Stress Disorders Final Exam PDF

FAIR GAME SHEET FINAL EXAM STRESS DISORDERS Reactions to extreme trauma - Intrusive recollections (daytime flashbacks, nightmares, illusions), and acute distress upon cues suggestive of the trauma - Dissociative symptoms (“psychic numbing”): their presence in stress disorders is associated w...

FAIR GAME SHEET FINAL EXAM STRESS DISORDERS Reactions to extreme trauma - Intrusive recollections (daytime flashbacks, nightmares, illusions), and acute distress upon cues suggestive of the trauma - Dissociative symptoms (“psychic numbing”): their presence in stress disorders is associated with greater impairment – emotional detachment – being in a “daze” – dropping out of usual activities, e.g., “going off the grid” – avoidance of topics related to trauma – forgetting or “fogginess” re: key aspects of trauma (“Dissociative amnesia”, seen frequently in combat veterans as part of “shell shock”) Dissociations: – time distortion (usually “slow-motion”) – feeling that the current setting is “dreamlike,” not real, and not registering events in surroundings (derealization) – feeling detached from one’s body (depersonalization ) - Chronic hyperarousal (always on edge): exaggerated startle, insomnia, hypervigilance, motor restlessness (agitation) - Irritability and aggressiveness (especially males) - Survival guilt / shame – belief that one doesn’t deserve to live when others have died (guilt), and that one has been marginalized (shame) you are embarrassed of being alive, to have to explain why you are alive - Reckless, impulsive behaviors (may relate to survival guilt/shame) act in ways that can promote your death Experiences of depersonalization and derealization ○ (derealization) feeling that the current setting is “dreamlike,” not real, and not registering events in surroundings ○ (depersonalization) feeling detached from one’s body Acute Stress Disorder and PTSD: basic difference, risk factors, treatment ○ Acute Stress disorder: extreme levels of anxiety, insomnia, inability to concentrate, withdrawal from life and work ○ PTSD: if symptoms of acute SD persist for more than or equal to 1 month. Perecipitants: sexual violence (highest risk in non-college females 18-24), military combat, physical/emotional abuse, human calamities (bombings, torture), physical trauma, limatic calamities (floods, earthquakes)  Risk factors: severity/time length of trauma and following life events, family history, current depression/anxiety, poor coping habits, minority ethnic status, intergenerational trauma (culture teaches to “don't trust others”), epigenetics, poor social support Nature of “Delayed Expression” syndrome ○ PTSD develops even when there was no diagnosable acute stress disorder (no symptoms for a month) Complex PTSD – etiology and differences from PTSD - Special case of PTSD reserved for repeated or continuous trauma over months or years. - Symptoms can be more extreme and longer-lasting than with “simple” PTSD. - Common kinds of CPTSD trauma: – being a victim of neglect or emotional, physical and/or sexual abuse – growing up in a family with domestic abuse – being a POW or living in a war zone – being a victim of human trafficking – having a series of illnesses, medical procedures, surgeries - Associated w/ usual PTSD signs and symptoms but also: – changes in worldview, religion, philosophy, basic trust, and views of relationships – preoccupation with traumatic history and revenge fantasies toward abusers Critical Incident Stress Debriefing: Basic steps - Fact phase: Ask victims to tell their stories. - Reaction phase: Ask victims to report their thoughts and feelings about the incident. - Symptom phase: Solicit symptomatology and suggest coping strategies. - Teaching phase: Educate victim regarding traumas and typical reactions to trauma. - Reentry phase: Wrap-up, answer Q’s, provide referrals, develop plan of action. 1st-line PTSD treatment - psychotherapeutic treatment: exposure therapy relying on visualization of trauma-related cues, combined with relaxation, to extinguish conditioned fear responses. - Cognitive-Behavior Therapy, esp. skills training focusing on “thought neutralization” - EMDR - Eye movement desensitization / reprocessing; based on dubious neurological model, with no evidence for special effectiveness compared to generic supportive therapy - Polyvagal therapy – Like EMDR, based on a dubious neurological model, but focuses on bodily awareness and anxiety reduction (reduces anxiety to be able to talk about trauma) - Group therapy / self-help (rap) groups: for estrangement, catharsis and support - Stress management training (structuring life-space, to-do lists, setting priorities) - For CPTSD sufferers, realign or reframe relationship with abuser(s) (like write a letter to them) - Finding meaning in tragedy (“sublimation”) PERSONALITY DISORDERS (AND SEE QUESTION II) Predominant features of each Personality Disorder as presented in lectures and text, including Passive- Aggressive Personality Disorder (Provisional) ○ Cluster A “odd, eccentric” Paranoid PD - doesn't trust anyone, everyone is out to get them, assumes the worst Schizoid PD - “loners,” no desire for social relationships, no emotion Schizotypal PD - schizoid traits PLUS odd/eccentric behaviors, thinking they have special powers, bodily illusions, high social anxiety (note: most do not progress to actual schizophrenia) ○ Cluster B “dramatic, emotional, unstable” Borderline PD - constant pattern of instability in relationships, impulsivity, dramatic outbursts (splitting), random intense anger (transient psychotic episodes) self-damaging behaviors Antisocial PD - may be applied to individuals who keep breaking the law, can include sociopaths and psychopaths Narcissistic PD - grandiose sense of self-importance or uniqueness, need for admiration, lack of empathy. (Types include grandiose, malignant, vulnerable, communal) Histrionic PD - increased emotionality and attention-seeking behaviors, always need to be the center of attention and will do anything to be just that. ○ Cluster C “anxious, apprehensive” Avoidant PD - hypersensitive to rejection or ridicule, wants relationships but too scared, social withdrawal, low self-esteem Dependent PD - constant need to be taken care of, see themselves as helpless or stupid, tolerate abusive relationships Obsessive-Compulsive PD - preoccupied by small details to the point of neglecting the goal, perfectionism that interferes with everyday tasks, very inflexible and can be indecisive due to the fear of making mistakes. ○ OTHER: Passive-Aggressive PD - continuous pattern of negative attitudes, procrastination, intentional inefficiency, stubbornness, always arriving late and excuse making, complaining about unreasonable demands, inflicting emotional blackmail, unacknowledged hostility “Symptomatic treatment” for Personality Disorders ○ Medication: treating what bothers the patient (depression, anxiety, psychosis) ○ Long-term therapy Borderline Personality Disorder:  o Risk factors o Etiological hypotheses - Early physical or sexual abuse - Psychoanalytic theory: failure to master separation from mother/faulty family boundaries, invalidating environment in childhood o Explanation of self-mutilation and dissociation - People with borderline PD may self-mutilate to focus their mental pain onto something else (dissociating by cutting, etc.). They may also do this to gain the attention of someone leaving them. o “Transient psychotic episodes” and “splitting” - Transient psychotic episodes: Disproportionate anger and sudden mood shifts - Splitting: thinks a person is either 100% good or 100% bad o Basic Elements of Dialectical Behavior Therapy - Developed for parasuicidal patients with borderline PD - “Environment of acceptance” - Weekly sessions to track therapy interfering behaviors - Mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness (problem-solving) Antisocial Personality Disorder: o Relationships among psychopathy, sociopathy and Antisocial Personality Disorder - Psychopathy: complete lack of empathy and interpersonal regard, may be diagnosed with antisocial PD but not the other way around. NOT a mental disorder, rather a neurodivergent condition. Note: not all psychopaths will be diagnosed with Antisocial PD. - Sociopathy: people who are socialized (usually born into) criminal lifestyles. Usually referred to criminal justice and not mental health systems. o Predominant features of Antisocial Personality Disorder, including when the diagnosis is usually made. - Conduct disorder before age 18, antisocial PD after age 18 o Psychopathy: § Risk factors - Frequent substance abuse - Conduct disorder - Linked to low socioeconomic levels, missing fathers - Frequent criminal acts or moral offenses - Strong genetic heritability § Etiological hypotheses - Cortical immaturity (prefrontal dysfunction in brain) - Low arousal hypotheses (insensitivity to reward / punishment) § Psychopathy and physiological arousal - Very low autonomic arousal to stress may explain the need to always be engaging in risky and dangerous behavior, to “feel something”  § Evidence-based treatment - Incarceration § “Successful” psychopaths - Often charming and intelligent to get what they want, sometimes evading the criminal justice system Contrast between OCD and Obsessive-Compulsive Personality Disorder ○ OCD: people know they have a problem ○ OCD PD: people don't recognize they have a problem, perfectionists Text Addendum: “Meaning and the Temporal Lobes: Is God in the Amygdala?” o TLE and dissociative phenomena - Temporal lobe epilepsy (TLE) is due to the hyperactivation of the amygdala which cause partial seizures - Complex partial seizures may cause a brief period (1-2minutes) of a dissociation which is spiritual and can cause people to be hyper religious. o Personality changes associated with Complex Partial Seizures (“Geschwind Syndrome”) - Changes may include obsessions with small details (everything is significant), excessive talkativeness, interpersonal viscosity (keeps telling stories), diminished sense of humor due to hypermorality, hyperreligiosity, fetishism and sexual disinterest (believe they are on a journey) SCHIZOPHRENIA (AND SEE QUESTION II) General features of psychotic disorders ○ Delusions (fixed beliefs without real evidence) Grandiose (special status or abilities Persecutory (someone is out to get them) Somatic (one is rotting away or disfigured) Religious (on a mission from God, or one has sinned) Sexual (one is a pedophile or rapist, masturbation caused their illness) Nihilistic (one is dead or the world does not exist) ○ Hallucinations (experiences that seem real but occur without external stimulus) ○ Disorganized thinking (derailment, “word salad”) ○ Disorganized motor behavior (repetitive bizarre movements) Definitions of Brief Psychotic Disorder and Schizoaffective Disorder ○ Brief psychotic disorder: delusions, hallucinations, disorganized speech or behavior lasts for less than one month. (not a drug reaction, half will progress to schizophrenia) ○ Schizoaffective disorder: Schizophrenic people who also have a history of depression and/or mania. Dementia praecox and Bleuler’s view of primary vs. restitutional symptoms. ○ Dementia Praecox: “premature dementia” was what schizophrenia was historically thought to be (by Kraeplin and Morel).  ○ Bleuler though schizophrenia as “shattered mind” Primary symptoms: disordered thinking Restitutional symptoms: hallucinations and delusions (to restore a coherent inner world) Typical manifestations of Schizophrenia (either + or - ) ○ Dramatic loss of functioning ○ Similar to autistic thinking and speech ○ Formal thought disorder ○ Disordered emotionality ○ Social withdrawal ○ Motor abnormalities Risk factors: Genetic predisposition, consanguinity, concordances (you do not need to remember specific concordances), infectious agents, birth trauma, sperm, etc. ○ Genetic: higher chance if one parent is schizophrenic, highest chance if both are ○ Birth complications (forceps deliveries) ○ Maternal malnutrition ○ Season of birth (due to infection season) ○ Maternal infectious agents: Influenza virus (highest risk at 6 months) Rubella virus (measles) Toxoplasmosis spores carried by cat feces Endogenous retrovirus (herpes simplex 2) ○ Older sperm (mutations with age) ○ Cannabis (especially in adolescent males) Seasonality effects in schizophrenic births ○ Likelier in feb-march to have schizophrenia, due to the pregnancy period being during flu season Factors involved in violence by people with Schizophrenia. ○ Highest only if they have a history of violence, and/or dont take their medication Marijuana and Schizophrenia risk (and see Text Addendum “Does Marijuana Cause Mental Disorders” cited below) ○ 3% higher chance in adolescents that have smoked cannabis over 50 times Positive vs. negative signs/symptoms of schizophrenia ○ Positive symptoms: paranoia, delusions, hallucinations ○ Negative symtpms: social withdrawal, flat effect, inertia, catatonia Differences in positive- vs. negative- sign/symptom-predominant schizophrenia: o Premorbid histories and course of illness History: Kraeplin thought it was a metabolic disorder, and Freudians thought it was due to a double-binding mother Modern view: scizophrenia a a neurodevelopmental disorder which begins with fetal brain mis-wiring. o Sex differences - (+): more females than males  - (-): more males than females o Differences in age of onset, prognosis - (+): later age of diagnosis (20-25), better prognosis - (-): earlier age of diagnosis (16-18), worse prognosis o Neuroanatomical / neurotransmitter changes - (+): More frequent dopamine changes, less chance of brain damage - (-): Infrequent dopamine changes, more chance of brain damage o Differences in medication effectiveness - (+): Better response to classical antipsychotics - (-): Poor response to classical antipsychotis Classical / atypical antipsychotic medications: o Motor and metabolic side effects of antipsychotic medications - Classic antipsychotics lower dopamine turnover in schizophrenics, but too low dopamine levels can cause pseudoparkinsonism, and vice versa: drugs that increase dopamine can cause a psychotic disorder that resembles schizophrenia - Tardive dyskinesia - Akathisia (thorazine shuffle, restlessness) - Increased risk of metabolic syndrome (weight gain, type 2 diabetes, elevated blood lipids) o Overall compliance rate with antipsychotic medications - Less than 30% compliance rate, because many schizophrenics do not believe in the medication and therefore do not take it o Advantages of atypical antipsychotic medications - Treats both (+) and (-) symptom schizophrenia - Much less persisitent movement side-effects - In clozaril, watch out for neutropenia Role of psychotherapy in schizophrenia ○ Adjust family, fiends, worklife to illness ○ Deal with pateints depression, anxiety from knowledge of illness ○ Symptom self-monitoring ○ Building compliance w medication World-wide trends in schizophrenia incidence and possible explanations ○ Schizophrenia appears to be declining world wide maybe due to Better prenatal and infant nutrition Safer childbirth methods Flu vaccine Overall outcomes in schizophrenia ○ Since more people are getting diagnosed with bipolar, the people with actual scizhophrenia do not show a good prognosis. Over half need to live at home with relatives. FEEDING AND EATING DISORDERS (AND SEE QUESTION II) General description of Avoidant/Restrictive Food Intake Disorder (ARFID) ○ Picky eating or disinterest in food leading to significant weight loss Prevalence as a function of sex and Westernization, and explanations ○ Males likelier to be obese, less likely to care about physical appearance ○ Weight-loss ads 10X more frequent in womens magazines ○ Females go on diets much more than males, may gateway to ED Types of males who are especially susceptible to eating disorders ○ Males in sports than emphasize weight control (boxing, wrestling, crew, jockeying), competitive body-building rather than agility or strength ○ Males active in the gay social scene Eating disorders: be able to define or identify from brief case descriptions Effectiveness of dieting as a weight-loss method. ○ Most dieting does not work because the weight is always gained back due to resetting of metabolic rate ○ The only successful weight loss method is a lifelong pattern of healthy eating, sleep, exercise Semaglutide use in eating disorders ○ Classified as GLP1’s, mimics the natural peptide made in the brain and intestines to lower blood sugar and reduce apetite. ○ To treat obesity Anorexia Nervosa Nature of body-image distortion ○ Person feels fat and believes he/she is fat even when obviously underweight ○ Intense fear of weight gain Susceptible populations ○ High-income countries (U.S., Europe, Australia, Japan, etc) ○ Runs in families, more frequent in female athletes/dancers, gay males, male wrestlers, models, etc. Altered eating habits ○ Restrictive: Limiting food intake to below normative requirements leading to a low BMI ○ Binge-eating / purging (worst) "Two P's" of Anorexia Nervosa (due to emptional reactivity and obsessive personality traits) ○ Powerlessness and perfectionism: if i can control my body, then i can have a perfect body and life. Bodily damage suffered in Anorexia Nervosa ○ Dry skin, thinning hair, hair loss, always cold ○ Amenorrhea (loss of menstruation)  ○ Cyanosis (blueing of toes and fingernails) ○ Chronic constipation ○ Enlarged salivary glands and tooth erosion from forced vomiting ○ Chest pain ○ Loss of muscle and osteoporosis (loss of bone density) ○ Loss of brain volume (cerebral atrophy) How Anorexia Nervosa is treated, and typical treatment outcome ○ Hospital: Intravenous or nasogastric tube, then eventually mouth feeding ○ Family therapy ○ Medication? Sometimes SSRI, but not really Bulimia Nervosa (recurrent binge eating, at least once for 3 months) Susceptible populations ○ Females peak ages 15 to 18 ○ College students “freshman 15” Types of compensatory behavior among people with Bulimia Nervosa ○ Purging: self0induced vomiting ○ Non-purging: extreme exercise and/or temporary fasting Bodily damage suffered in Bulimia Nervosa ○ From repeated vomiting: erosion of teath, osteoporosis, heart damahe, rupture of stomach or esophagus, swollid salivary glands, menstrual irregularities and pregnancu complications How Bulimia Nervosa is treated, and typical treatment outcome ○ Unlike anorexia, there is good treatment response, but relapse is common ○ 1st line: high doses of SSRI’s ○ Therapy Binge Eating Disorder Differences from Bulimia Nervosa ○ Most people are medically obese or have morbid obesity ○ Binge eating at least once a week without compensatory behavior Physical and psychological costs ○ Sleep apnea, type 2 diabetes, acid reflux, early mortality, immobility ○ Shame, guilt, social avoidance, embarassment at appearance, depression, anxiety ○ Additional treatments include semaglutides SUBSTANCE ABUSE/DEPENDENCE: Moral vs. Medical (Disease) views of “addiction”  ○ Moral: addicts are morally weak and choose to yield to temptation, careless, self-destructive. They need to get it together ○ Medical: Addicts are aided by a genetic predisposition. Once they start using, their brains become “hijacked” by the substances. They need treatment to block the hijacking to restore the brain, and tht will give them back their free will. “Use” vs. “abuse” and sociocultural norms ○ Use: ingesting a drug within sociocultural norms ○ Abuse: taking a drug outside of sociocultural norms, causing personal and social problems Overall differences among substance intoxication, abuse and dependence ○ Intoxication: Ingestion of a substance leading to impairment ○ Abuse: Harmful pattern of use ○ Dependence (worst): habitual abuse and development of cravings and tolerance Risk factors for ETOH dependence; Level of Response and predisposition to ETOH dependence ○ Loss of gray matter in hippocampus and inner cerebellum ○ Younger drinking predicts later problems (4X more before age 15) ○ Family history (4X) as likely ○ Ethnicity (mexicans, native americans) ○ College drinking ○ Unstable personality disorders, conduct/antisocial disorder ○ Males 4X more likely to have alcohol use disorders, but females that have it suffer more health problems ETOH withdrawal symptoms and management ○ Shakes, weakness, sweating, nausea, vomiting ○ Alcholoic seizures and unpleasant auditory hallucinations ○ Delirium tremens: confusion, disorientation, agitation, frightening visual hallucinations ○ Management: can be fatal if unsupervised, must be done in hospital or detox facility Contributors to current U.S. opioid crisis ○ Smuggled by cartels over the U.S. border ○ Black market fentanyl is 100X more potent than heroin, and accounts for 70% of opiod OD’s ○ Prescription pain relievers that are highly addictive Current strategies for dealing with opioid crisis ○ Better training of physicians for pain management (opiates should normally not be used over 30 days) ○ Substitution treatments such as Low potency opiates: methadone Abuse-deterrent formulations (ADF’s) of opiates: Suboxone ○ Rapid response OD training ○ Over-counter Narcan nasal spray for OD’s General modalities of addiction treatment (acute and rehabilitation phases)  ○ Acute treatment: inpatient detox facility for withdrawal symtoms, therapy ○ Rehabilitation: outpatient, denial of user that they have a problem ○ To treat co-morbid conditions: therapy/education programs, 12-step programs such as AA, support groups. General philosophy and operation of 12-step recovery groups ○ Medical view of causation, but a moral view of recovery: Admitting to the substance abuse problem Confessing the need for a higher power to succeed A vow to stay sober Making personal amends for the damage they have caused Helping others to achieve sobriety Trends in addiction treatment, with examples of pharmacological treatments ○ 12-step Abstinence groups remain an effective treatment ○ “Detox first” ○ Early education and school prevention programs ○ Pharmacological treatments (not cures, but successful at preventing abuse and relapse): Antagonists (dulls the buzz from alcohol) Maintenance treatments (methadone, nicorette gum, etc.) ADF’s (Vyvanse cant be snorted) General effectiveness of treatment for common addictions ○ Treatments for substance abuse disorders show low rates of abstinance Rationale for Abuse-Deterrent Formulations ○ ADF’s are chemically more difficult to abuse Text Addendum: “Does Marijuana Cause Mental Disorders?” o Mental-health risks of marijuana use: - 3% higher chance in adolescents that have smoked cannabis over 50 times, lung cancer, increased risk of heart attack/stroke, pneumonia, increased risk of anxiety/depression/psychosis, decline in IQ, 9% develop dependence for marijuana o Why marijuana use has become much riskier - Marijuana is now legalized and easier to access than ever. The % of THC now put in marijuana is alarmingly high, 10-100X more potent than in the past. o Established medical uses of marijuana - Pain management for nerve damage in patients with HIV, chemptherapy pain, stimulates apetite in AIDS patients, pateints with severe epilepsy, Text Addendum and Lecture: “Fetal Alcohol Spectrum Disorder” o Signs of, and risk factors for, FASD - Caused by mothers who drink alcohol during pregnancy: causes abnormal facial feautures and brain impairments (learning disabilities and low intelligence, hyperactivity)  - Severity of effects is determined by amount and frequency of alcohol consumption (applies to even before conception) - More likely to be incarcerated - Uneducated and poor mothers most at risk, little access to prenatal care o Amount of alcohol safe to drink in pregnancy NONE Text Addendum: “Korsakoff Syndrome” o Etiology of Korsakoff Syndrome - Caused by long-term alcoholism: malnutrition (loss of vitamin B1), severe meory loss (amnesia), they tend to make up stories rather than admit they don’t remember, they don’t believe they have a problem o Nature of amnesia in Korsakoff’s - Korsakoff’s cuases retrograde and anterograde amnesia ATTENTION-DEFICIT HYPERACTIVITY DISORDER (AND SEE QUESTION II) DSM-5-TR ADHD presentations with general features of each (6 or more symptoms ober 6 months) ○ Predominantly Hyperactive-Impulsive Presentation (Fidgeters) Always on the go, difficulty waiting turn, can’t sit still ○ Predominantly Inattentive Presentation (Dreamers) Poor attention to detail/careless mistakes, fail to follow instructions/finish assignments, avoid tasks requiring mental effort, very forgetful, lose things easily, difficultty organizing, easily overwhelmed Who is affected by ADHD (risk factors, sex differences, family and genetic contributions, course of disorder) ○ Genetic predisposition ○ 9:1 Male to Female ratio ○ Rates higher in children who Had prenatal complications, premature births or low birth weights Mothers drank and/or smoked High blood levels of lead Mothers had high anxiety during weeks 12-22 of pregnancy Had unstable living situations Had a traumatic brain injury Consequences of ADHD ○ Poor grades and conduct ○ Comorbidities: learning disabilities, depression/anxiety ○ For hyperactive type: substance abuse, conduct disorder, more traffic accidents, lose jobs, get pregnant, STD’s ○ 50% of inmates and kids in juvy have untreated ADHD. Psychostimulants – effectiveness, advantages, drawbacks and side effects of psychostimulants in general  ○ 70-80% are treated with psychostimulants ○ Side affects: insomnia, headache, nausea ○ Sustained use can cause premature closure of bone growth plates ○ Stimulants lowers rate of later substance abuse ○ May unmask tic disorder/tourette’s, or anxiety and hypomania in which they would need SSRI’s/mood stabilizers instead Behavioral treatments ○ Structuring school and home environments (rewards/punishments) ○ For older people: relaxation, yoga, etc. General risk and safety profile of psychostimulants ○ Psychostimulants do not help good performers ○ Long term and higher than normal dosing can cause psychosis and paranoia ○ Mixing with alcohol or drugs can be fatal ○ Vyvanse (ADF) prevents snorting or injecting ○ Overall, under regualr and prescribed dosing, they are safe and effective Common signs of adult ADHD ○ Prefer highly stimulating situations (noisy, busy places to get work done) ○ Difficutly waiting in lines ○ Tune out conversation ○ Blurt and make unwelcome remarks ○ Can often show special intuitiveness, “out of the box” approaches to problems AUTISTIC SPECTRUM DISORDER (Neurodevelopmental Disorder) General signs observed in Autistic Spectrum Disorder ○ Impairments in social interaction and communication ○ Restricted, repetitive patterns of behaviors / activities ○ Lower-functioning ASD: problems in communication, sensory problems, repetition (narrow set of interests) ○ Higher functioning ASD: Social impairment, repetitive interests / behavior Kanner’s etiology for “early infantile autism” (initially thought to be caused by child-rearing factors, this is not true anymore) ○ Kanner thought Autism was caused by children trying to “escape from reality” due to contradicting parents, and cold mothers that were emotionally withholding (refridgerator mothers) ○ Often confused with childhood schizophrenia Role of infant vaccines in risk of Autistic Spectrum Disorder ○ Evidence suggests that childhood vaccines do not increase incidence of ASD. Risk factors, treatments, brain findings. ○ Older fathers (gene mutations), Genetic links and chromosomal abnormalities ○ Over-abundance of neurons in the brain beginning in uterus (over-wiring of neurons) ○ Treatments: Behavorial interventions and medication  Lower-functioning: ABA (applied bahvior analysis) therapy focusing on group behavior and play Higher-functioning: social script training, management of relationships, sexual couseling Ritalin for ADHD-like behavior Anticonvulsants, antipsychotics, cannabinoids for outburst, seizures, etc II. BE ABLE TO DIAGNOSE FROM CASE DESCRIPTIONS: Types of Eating disorders. ○ Anorexia nervosa ○ Bulimia nervosa ○ Binge eating disorder Types of Personality disorders - Cluster A ODD disorders: schizoid, schizotypal, paranoid - Cluster B dramatic disorders: antisocial, histrionic, narcissist, borderline - Cluster C anxious disorders: dependent, obsessive-compulsive, avoidant Positive vs. negative syndrome subtypes of schizophrenia ○ Positive symptoms: paranoia, delusions, hallucinations ○ Negative symtpms: social withdrawal, flat effect, inertia, catatonia ADHD Presentations ○ Predominantly Hyperactive-Impulsive Presentation (Fidgeters) ○ Predominantly Inattentive Presentation (Dreamers)