AICM day 3

October-06-11 7:53 AM

Behaviour Science, Ethics, Stats 1. Development milestone a. 0-3 months (neonates reflexes appears by 3 months) i. Tonic Neck disappears at two months 1) If you move the neck right -- the baby will move the arm to the right ii. Grasping 1) Weakens at 3 months, disappears at 1 year iii. Moro aka parachute 1) Startled reflex, everytime there is a loud sound baby will try to hold something iv. Rooting 1) When u stimulate cheek it will move that way v. Sucking 1) Disappears at 3-4 months vi. Stepping 1) 3-4 month try to talk vii. Babinski 1) Disappears at 9months to 1 year b. 3 months i. Follow objects with eyes ii. Holds head up lift head with prone, social smile 1) Smile response to ppl , and this happens at 3 months , not before 3 months c. 4-5 months i. Rolls front to back, sit with support, attachment to primary care giver d. 7-9 i. At 7 months baby starts to cry if he see someone that he doesn't recognize ii. At 7 month voice orientation e. At 4 year old i. Child speaks in complete sentences f. Early childhood 2-3 years i. Toilet training g. Preschool (3-5 years) i. Exploration ii. Feeling of guilt h. Adolescence 12-18 years i. Identity vs Role Confusion 1) Looking for identity, develop relationships i. Young adulthood 19-40 years i. Relationships ii. Young adults need to form intimate loving relationships with other ppl j. Middle adulthood (40-65 years) i. Middle age crisis k. Maturity 65 to death i. Reflection on life l. Teenager identity formation is key m. 0-5 yr : no ceonception of death being an irreversible process n. > 8years : understand death as irreversible 2. Behaviour disorder a. ADHD i. Attention deficit ii. Symptoms > 6 months iii. More common in males
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More common in males Easily distracted, short attention, forget things Hyper active Day dream Accident prone Needs to happen in two places (home n school etc) and needs to have symptoms for more than 6 months ix. Very impatient Conduct disorder i. Difficulty following rules and behaving in socially acceptable way. ii. Bullies, threatens or intimidates other iii. Physical fights iv. Cruel to ppl n animals v. After 18 years old = called antisocial personality Oppositional defiant disorder i. Frequent temper tantrums ii. Excessive arguing with adults iii. Often questioning rules iv. Active defiance and refusal to comply with adult requests n rules v. Freq anger n resentment vi. Prblem with anyone in authority vii. Treatment: 1) Parent management training prog 2) Individual psychotherapy 3) Family psychotherapy Tourette's syndrome i. Usuallly occur between 7-8 years ii. Onset before 18 years of age iii. Motor and vocal tics iv. Involuntary use of profanity (rare) Separation anxiety disorder i. Tremendous fear of loss of a major attachment figure ii. Fear leads to physical complaints to avoid being separated iii. May occur in preschool iv. Most common in 7-8 years of age v. Treatment: 1) Psychotherapy 2) SSRIs can be helpful a) Selective Serotonin Selective Mutism i. More common in girls ii. Differentiate from normal shyness iii. Chidl had ability to speak well but now is mute iv. Resfusal to speak in some or all social situations v. Communications might be gestures vi. Ability to speak at home present vii. Caused by anxiety biological/environmental/social factors Pervasive developmental disorders Autism i. It has multiple spectrum 1) Repetitive motions 2) Hit themselves 3) Dont pay attention to others 4) Can do same movement for multiple hours ii. Onset before 3 yr of age Asperger's Syndrome i. Milder form of autism ii. Problem interacting with their peers
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ii. Problem interacting with their peers iii. Normal verbal n cognitive skills iv. Repetitive behaviour j. Rett's disorder i. X linked (only in girls) ii. Hand wringing iii. Appear at 4 years iv. Loss of social, verbal n cognitive development which leads to mental retardation Mental retardation a. Fetal alcohol syndrome is the highest cause of mental retardation Child abuse a. Always need to report b. Diagnosis: i. Broken ii. Fractures in long bones in children that dont walk iii. Healed fracture on x-ray iv. Bruises n burns c. Ex on usmle: in case of child abuse the most imp step 1st is to give IV fluids and pain medications Sleep n Sleep disorder a. Sleep 3 n 4 are characterised by Delta waves b. Sleep walking, Night terrors, bed wetting c. Benzodiazepines and Imipramine shorten Stage 3 n 4 d. Narcolapsy i. Cataplexy --> losses motor control ii. Sleep paralysis : person wakes up but body cant move at all e. Insomia i. Must be atleast 3 times a week for atleast 1 month f. Sleep Apnea i. Stop breathing for a brief period of time during sleep ii. Usually stop breathing for 20-30 secs g. Sleep terror disorder i. Occurs in stage 3 n 4 (slave wave sleep) h. Circadian Rhythm Personality Trait Histrioni Ex a. c You have a pt in the office, seducing you, and if you decline turn a lil rude .

b. Splitting is the main line of defence for people with borderline personality trait 7. Defence Mechanism 8. Psychotics Disorder a. Schizophrenia i. Usually more common in males ii. You need to have the symptoms for atleast 6 months iii. Periods of psychosis: 1) Loss of touch with reality 2) Hallucinations 3) Delusions iv. Related to too much dopamine in the brain 1) Most of the drugs in a way that they block Dopamine receptors v. Haloperidol or fluphenazine (high Potency) 1) Know Adverse Effects 2) Acute dystonia a) Severe muscle spasm 3) Akathisia a) Hyperactivity 4) Tardive dyskinesia is not reversible it will stay while other adverse effect will go away when drug is removed
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go away when drug is removed b. Bi-polar disorder i. U need only one episode of maniac episodes more than 1 WEEK 1) Maniac - hyper, all the transmitters in your brain are high ii. Treatment : Lithium and almost forever c. Dysthymia i. More common in women 9. Anxiety disorder a. Need to have symptoms for at least 6 months b. OCD c. Personality compulsive disorder VS OCD i. PCD -- he is ok with it there is no prb with it ii. OCD -- they have suicidal thoughts they want to change but cant change it d. Panic disorder vs panic attack i. In a panic disorder there is no stimulus e. Bulimia Vs anorexia i. Bulimic pt have their menstrual cycle while Anorexia pt dont f. Factitious vs malingering i. Factitious is just for attention no secondary gain while malingering has some secondary gain 10. Cognitive disorder

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