Contents

1. THE BEGINNING OF LIFE: PREGNANCY THROUGH
   PRESCHOOL 1
   I. Childbirth and the Postpartum Period 1
   II. In ancy: Birth to 15 Months 3
   III. The Toddler Years: 15 Months–2½ Years 5
   IV. The Preschool Child: 3–6 Years 6
   Review Test 8
2. SCHOOL AGE, ADOLESCENCE, SPECIAL ISSUES OF
   DEVELOPMENT, AND ADULTHOOD 15
   I. School Age: 7–11 Years 15
   II. Adolescence: 11–20 Years 16
   III. Special Issues in Child Development 18
   IV. Early Adulthood: 20–40 Years 19
   V. Middle Adulthood: 40–65 Years 19
   Review Test 20
3. AGING, DEATH, AND BEREAVEMENT 25
   I. Aging 25
   II. Stages o Dying and Death 27
   III. Bereavement (Normal Grie ) Versus Complicated Bereavement
   (Depression) 27
   Review Test 29

4. GENETICS, ANATOMY, AND BIOCHEMISTRY
   OF BEHAVIOR 34
   I. The Genetics o Behavior 34
   II. The Neuroanatomy o Behavior 35
   III. Neurotransmission 37
   IV. Biogenic Amines 38
   V. Amino Acid Neurotransmitters 41
   VI. Neuropeptides 41
   Review Test 42
5. BIOLOGICAL ASSESSMENT OF PATIENTS WITH
   PSYCHIATRIC SYMPTOMS 49
   I. Overview 49
   II. Measurement o Biogenic Amines and Psychotropic Drugs 49
   III. Evaluating Endocrine Function 50
   IV. Neuroimaging and Electroencephalogram Studies 50
   V. Neuropsychological Tests 51
   VI. Other Tests 52
   Review Test 53
6. PSYCHOANALYTIC THEORY AND DEFENSE MECHANISMS 57
   I. Overview 57
   II. Freud’s Theories o the Mind 57
   III. De ense Mechanisms 58
   IV. Trans erence Reactions 58
   Review Test 61
7. LEARNING THEORY 65
   I. Overview 65
   II. Habituation and Sensitization 65
   III. Classical Conditioning 66
   IV. Operant Conditioning 66
   Review Test 69
8. CLINICAL ASSESSMENT OF PATIENTS WITH BEHAVIORAL
   SYMPTOMS 74
   I. Overview o Psychological Testing 74
   II. Intelligence Tests 74

III. Achievement Tests 75
IV. Personality Tests 76
V. Psychiatric Evaluation o the Patient with Emotional Symptoms 76
Review Test 79

9. SUBSTANCE-RELATED DISORDERS 83
   I. Substance-related Disorders: Def nitions, Epidemiology, and
   Demographics 83
   II. Stimulants 84
   III. Sedatives 85
   IV. Opioids 87
   V. Hallucinogens and Related Agents 88
   VI. Clinical Features o Substance-related Disorders 89
   VII. Management 90
   Review Test 91
10. NORMAL SLEEP AND SLEEP DISORDERS 98
    I. Normal Awake and Sleep States 98
    II. Classif cation o Sleep Disorders 100
    III. Insomnia 100
    IV. Breathing-related Sleep Disorder (Sleep Apnea) 102
    V. Narcolepsy 102
    VI. Management o Sleep Disorders 103
    Review Test 104
11. SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOTIC
    DISORDERS 111
    I. Schizophrenia 111
    II. Other Psychotic Disorders 114
    Review Test 116
12. DEPRESSIVE DISORDERS AND BIPOLAR AND RELATED
    DISORDERS 121
    I. Overview 121
    II. Classif cation o Depressive and Bipolar Disorders 122
    III. Etiology 124
    IV. Management 126
    Review Test 127

13. ANXIETY DISORDERS, SOMATIC SYMPTOM DISORDERS,
    AND RELATED CONDITIONS 132
    I. Anxiety Disorders 132
    II. Somatic Symptom and Related Disorders 135
    III. Factitious Disorder, Factitious Disorder Imposed on Another, and
    Malingering 136
    Review Test 137
14. NEUROCOGNITIVE, PERSONALITY, DISSOCIATIVE, AND
    EATING DISORDERS 144
    I. Neurocognitive Disorders 144
    II. Personality Disorders 148
    III. Dissociative Disorders 149
    IV. Obesity and Eating Disorders 150
    Review Test 153
15. PSYCHIATRIC DISORDERS IN CHILDREN 160
    I. Autism Spectrum and Related Disorders 160
    II. Attention Def cit/Hyperactivity Disorder, Oppositional Def ant Disorder
    and Conduct Disorder 161
    III. Other Disorders o Childhood 163
    Review Test 164
16. BIOLOGIC THERAPIES: PSYCHOPHARMACOLOGY 169
    I. Overview 169
    II. Antipsychotic Agents 169
    III. Antidepressant Agents 171
    IV. Mood Stabilizers 175
    V. Antianxiety Agents 175
    VI. Psychoactive Medications in Pregnancy 176
    VII. Electroconvulsive Therapy and Related Therapies 177
    Review Test 179
17. PSYCHOLOGICAL THERAPIES 187
    I. Psychoanalysis and Related Therapies 187
    II. Behavioral Therapies 188
    III. Other Therapies 189
    Review Test 191

18. THE FAMILY, CULTURE, AND ILLNESS 195
    I. Overview o the Family 195
    II. Demographics and Current Trends 195
    III. Culture in the United States 197
    IV. American Subcultures 198
    Review Test 200
19. SEXUALITY 205
    I. Sexual Development 205
    II. The Biology o Sexuality in Adults 206
    III. Sexual Dys unction 207
    IV. Paraphilias and Paraphilic Disorders 209
    V. Illness, Injury, and Sexuality 210
    VI. Aging and Sexuality 210
    VII. Drugs and Sexuality 211
    VIII. The Human Immunodef ciency Virus and Sexuality 211
    Review Test 213
20. AGGRESSION AND ABUSE 220
    I. Aggression 220
    II. Abuse and Neglect o Children, the Elderly, and Impaired Persons 221
    III. Physical and Sexual Abuse o Domestic Partners 223
    IV. The Role o the Physician in Suspected Child, Elder, and Domestic
    Partner Abuse 224
    V. Sexual Aggression: Rape and Related Crimes 224
    Review Test 226
21. THE PHYSICIAN–PATIENT RELATIONSHIP 232
    I. Medical Practice 232
    II. Adherence 233
    III. The Clinical Interview 235
    Review Test 238
22. PSYCHOSOMATIC MEDICINE 248
    I. Stress and Health 248
    II. Psychological Stress in Specif c Patient Populations 250
    III. Patients with Chronic Pain 251
    IV. Patients with Acquired Immune Def ciency Syndrome 252
    Review Test 253

23. LEGAL AND ETHICAL ISSUES IN MEDICINE 258
    I. Legal Competence 258
    II. In ormed Consent 259
    III. Conf dentiality 260
    IV. Reportable Illnesses 260
    V. Ethical Issues Involving HIV In ection 261
    VI. Involuntary and Voluntary Psychiatric Hospitalization 261
    VII. Advance Directives 262
    VIII. Death and Euthanasia 262
    IX. Medical Malpractice 263
    X. Impaired Physicians 264
    Review Test 265
24. HEALTH CARE IN THE UNITED STATES 278
    I. Health Care Delivery Systems 278
    II. Costs o Health Care 280
    III. Payment or Health Care: Health Insurance 280
    IV. Demographics o Health in the United States 283
    Review Test 285
25. MEDICAL EPIDEMIOLOGY 290
    I. Medical Epidemiology: Incidence and Prevalence 290
    II. Research Study Design 291
    III. Quanti ying Risk 291
    IV. Bias, Reliability, and Validity 293
    V. Clinical Probability and Attack Rate 296
    Review Test 298
26. STATISTICAL ANALYSES 306
    I. Elements o Statistical Analyses 306
    II. Hypothesis Testing 309
    III. Statistical Tests 310
    Review Test 312
    Comprehensive Examination 317
    Index 353

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