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Chapter 5: Behavior and Mental Status
Bates Ch 5: Behavior and Mental Status
101
Medical
Graduate
12/19/2010

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Term
What is the prevalence (%) of mental disorders in the US?
Definition
30%
Term
What type of symptoms relate to a body sensation such as pain, fatigue, or palpitations?
Definition
physical symptoms
Term
What type of symptoms relate to mood or anxiety?
Definition
psychological symptoms
Term
What type of symptom lacks an adequate medical or physical explanation?
Definition
somatoform symptom
Term
Unexplained conditions lasting longer than 6 weeks are increasingly recognized as common chronic disorders that should prompt screening for what disorders?
Definition
depression, anxiety, or both
Term
Name the patient identifiers for mental health screening.
Definition

-medically unexplained physical symptoms

-multiple physical or somatic symptoms or "high symptom count"

-high severity of the presenting somatic symptom

-chronic pain

-symptoms for more than 6 weeks

-physician rating as a "difficult encounter"

-recent stress

-low self-rating of health

-high use of healthcare services

-substance abuse

Term
What term encompasses character disorders in which patients have dysfunctional interpersonal coping styles that disrupt and destabilize their relationships, including those with health care providers? 
Definition
personality disorders
Term
Distrust and suspiciousness are the key characteristics of this personality disorder.
Definition
paranoid personality disorder
Term
Detachment from social relationships with a restricted range of emotional expression are key characteristics of what personality disorder?
Definition
schizoid personality disorder
Term
This personality disorder is mainly characterized by eccentricities in behavior and cognitive distortions and acute discomfort in close relationships.
Definition
schizotypal personality disorder
Term
What personality disorder is characterized by disregard for others and a defect in the experience of compunction or remorse for harming others?
Definition
antisocial personality disorder
Term
This personality disorder is characterized by an instability in interpersonal relationships, self-image, and affective regulation.
Definition
borderline personality disorder
Term
What personality disorder is described by emotional overreactivity, theatrical behavior, and seductiveness?
Definition
histrionic personality disorder
Term
Which personality disorder is described by social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation?
Definition
avoidant personality disorder
Term
What personality disorder is characterized by persisting grandiosity, need for admiration, and lack of empathy for others?
Definition
narcissistic personality disorder
Term
What personality disorder is characterized by submission and clinging behavior?
Definition
dependent personality disorder
Term
What personality disorder is described by rigid, detail-oriented behavior, often associated with compulsions to perform tasks repetitively and unnecessarily?
Definition
Obsessive-compulsive personality disorder
Term
What term describes alertness or state of awareness of the environment?
Definition
level of consciousness
Term
What term encompasses the ability to focus or concentrate over time on one task or activity-an inattentive or distractable person with impaired consciousness has difficulty giving a history or responding to questions?
Definition
attention
Term
What term is described by the process of registering or recording information, tested by asking for immediate repetition of material, followed by storage or retention of information?
Definition
memory
Term
This type of memory covers minutes, hours, or days.
Definition
recent or short-term memory
Term
This type of memory refers to intervals of years.
Definition
remote or long-term memory
Term
What term includes awareness of personal identity, place, and time and requires both memory and attention?
Definition
orientation
Term
What term encompasses sensory awareness of objects in the environment and their interrelationships (external stimuli) and also refers to internal stimuli such as dreams and hallucinations?
Definition
perceptions
Term
What term includes the logic, coherence, and relevance of the patient's thought as it leads to selected goals, or how people think?
Definition
thought processes
Term
What term is described by what the patient thinks about, including level of insight and judgment?
Definition
thought content
Term
What term includes awareness that symptoms or disturbed behaviors are normal or abnormal (for example distinguishing between daydreams and hallucinations that seem real)?
Definition
insight
Term
What term includes process of comparing and evaluating alternatives when deciding on a course of action and reflects values that may or may not be based on reality and social conventions or norms?
Definition
judgment
Term
Which term is characterized by an observable, usually episodic, feeling or tone expressed through voice, facial expression, and demeanor?
Definition
affect
Term
What term is described by a more sustained emotion that may color a person's view of the world?
Definition
mood
Term
Which term is described by a complex symbolic system for expressing, receiving, and  comprehending words?
Definition
language
Term
Which term can be assessed by vocabulary, fund of information, abstract thinking, calculations, construction of objects that have two or three dimensions?
Definition
higher cognitive functions
Term
If worries persist for over a 6-month period, what disorder should be considered?
Definition
Generalized anxiety disorder
Term
If a patient has recurrent panic attacks followed by a period of anxiety about further attacks, which disorder should be considered?
Definition
panic disorder
Term
Which disorder is characterized by avoidance, numbing, and hyperarousal and is often provoked by a traumatic event?
Definition
Post-traumatic stress disorder
Term
Which disorder is characterized by marked anticipatory anxiety in social situations?
Definition
social phobia
Term
Which disorder is a common medical illness and frequently coexists with other mental disorders, noteably anxiety disorders and substance abuse?
Definition
Major depression
Term
Which sex is more likely to have major depression?
Definition
females (2x as likely)
Term
List some signs of major depression.
Definition

-low self-esteem

-loss of pleasure in daily activities (anhedonia)

-sleep disorders

-difficulty concentrating or making decisions

Term
List some risk factors for suicide.
Definition

-prior suicide attempts

-delusional or psychotic thinking

-FHx of suicide

-mental disorders

-substance abuse

-family violence, including physical or sexual abuse

-firearms in the home

-incarceration

Term
Which word describes phrases or sentences which are substituted for a word the person cannot think of, such as "what you write with" for "pen"?
Definition
circumlocutions
Term
Which word describes word malformation such ("I write with a den"), wrong ("I write with a bar"), or invented ("I write with a dar")?
Definition
paraphasias
Term
Hesitancies and gaps in the flow and rhythm of words, disturbed inflections, circumlocutions, and paraphasias are suggestive of what disorder?
Definition
aphasia
Term
What level of consciousness is displayed when a patient is drowsy but open their eyes and look at you, respond to questions, and then fall asleep?
Definition
lethargy
Term
What level of consciousness is displayed when a patient opens their eyes and looks at you, but respond slowly and are somewhat confused?
Definition
obtundation
Term
What specifically is being tested when you ask a pt to follow a one-stage command such as "Point to your nose" or a two stage command such as "Point to your mouth, then your knee"?
Definition
word comprehension
Term
What specifically is being tested when you ask a pt to name the parts of a watch?
Definition
Naming
Term
What specifically is being tested when you ask a patient to repeat a phrase of one syllable words like "No ifs, ands, or buts"?
Definition
repetition
Term
What specifically is being tested when you ask a pt to read a paragraph aloud?
Definition
reading comprehension
Term
When you ask a pt to write a sentence, what are you testing?
Definition
Writing ability
Term
Sadness, deep melancholy, contentment, joy, euphoria, elation, and anger are all types of what?
Definition
mood
Term
What is the term for speech characterized by indirection and delay in reaching the point because of unnecessary detail, although components of the description have a meaningful connection?
Definition
circumstantiality
Term
What is the term for speech in which a person shifts from one object to others that are unrelated or related only obliquely without realizing that the subjects are not meaningfully connected?
Definition
derailment (loosening of associations)
Term
What term is characterized by an almost flow of accelerated speech in which a person changes abruptly from topic to topic and changes are usually based on understandable associations, plays on words, or distracting stimuli, but the ideas do not progress to sensible conversation?
Definition
Flight of ideas
Term
What term is characterized by invented or distorted words, or words with new and highly idiosyncratic meanings?
Definition
neologisms
Term
What term is characterized by speech that is largely incomprehensible because of illogic, lack of meaningful connections, abrupt changes in topic, or disordered grammar or worse use?
Definition
incoherence
Term
What term is characterized by sudden interruption of speech in midsentence or before completion of an idea and the person attributes this to losing the thought?
Definition
blocking
Term
What term is characterized by fabrication of facts or events in response to questions, to fill in the gaps in an impaired memory?
Definition
confabulation
Term
What term is characterized by persistent repetition of words or ideas?
Definition
perseveration
Term
What term is characterized by repetition of the words and phrases of others?
Definition
echolalia
Term
What term is characterized by speech in which a person chooses a word on the basis of sound rather than meaning, as in rhyming and punning speech?
Definition
clanging
Term
What term is described by repetitive behaviors or mental acts that a person feels driven to perform in order to produce or prevent some future state of affairs, although expectation of such an effect is unrealistic?
Definition
compulsions
Term
What term is described by recurrent, uncontrollable thoughts, images, or impulses that a person considers unacceptable and alien?
Definition
obsessions
Term
What term describes persistent, irrational fears, accompanied by a compelling desire to avoid the stimulus?
Definition
phobias
Term
What term is encompassed by apprehensions, fears, tensions, or uneasiness that may be focused (phobia) or free-floating (a general sense of ill-defined dread or impending doom)?
Definition
anxieties
Term
What term is characterized by a sense that things in the environment are strange, unreal, or remote?
Definition
feelings of unreality
Term
What term describes a sense that one's self is different, changed, or unreal, or has lost identity or become detached from one's mind or body?
Definition
feelings of depersonalization
Term
What term describes false, fixed, personal beliefs that are not shared by other members of the person's culture or subculture?
Definition
delusions
Term
What type of delusion occurs when a person believes that external events, objects, or people have a particular and unusual personal significance?
Definition
delusions of reference
Term
What delusion is characterized by believing one has a disease, disorder, or physical defect?
Definition
somatic delusion
Term
What is the term for misinterpretations of real external stimuli?
Definition
illusions
Term
What term is described by subjective sensory perceptions in the absence of relevant external stimuli and the person may or may not recognize the experiences as false?
Definition
hallucinations
Term
What do the digit span, serial 7's, and spelling the word "world" backward assess?
Definition
attention
Term
Asking a pt to interprete proverbs or asking about the similarities between two objects is assessing what?
Definition
abstract thinking
Term
Name the chronic, multisystem disorder characterized by complaints of pain, GI, and sexual dysfunction, and pseudoneurologic symptoms where onset is early in life and psychosocial and vocational achievements are limited.
Definition
somatization disorder
Term
Name the disorder in the syndrome of symptoms of deficits mimicking neurologic or medical illness in which psychological factors are judged to be of etiologic importance?
Definition
conversion disorder
Term
Name the disorder which is a clinical syndrome characterized predominately by pain in which psychological factors are judged to be of etiologic importance.
Definition
pain disorder
Term
Name the disorder in which there is a chronic preoccupation with the idea of having a serious disease and the preoccupation is poorly amenable to reassurance.
Definition
hypochondriasis
Term
Name the disorder in which there is a preoccupation with an imagined or exaggerated defect in physical appearance.
Definition
body dysmorphic disorder
Term
Name the disorder in which there is intentional production or feigning of physical or psychological signs when external reinforcers are clearly not present.
Definition
factitious disorder
Term
Name the disorder in which there is intentional production or feigning of physical or psychological signs when external reinforcers are present.
Definition
malingering
Term
What disorders are characterized by disruptions of consciousness, memory, identity, or perceptions judged to be due to psychological factors?
Definition
dissociative disorders
Term

What type of disorder is characterized by at least five of the following symptoms (including one of the first two) must be present during the same two week period:

-depressed mood most of the day, nearly every day

-markedly diminished interest or pleasure in almost all activities most of the day, nearly every day

-significant weight gain or loss (not dieting) or increased or decreased appetite nearly every day

-insomnia or hypersomnia nearly every day

-psychomotor agitation or retardation nearly every day

-fatigue or loss of energy nearly every day

-inability to think or concentrate or indecisiveness nearly every day

-feelings of worthlessness or inappropriate guilt nearly every day

-recurrent thoughts of death or suicide or a specific plan for or attempt at suicide

Definition
major depressive episode
Term

What disorder is characterized by a distinct period of abnormally and persistently elevated, expansive, or irritable mood must be present for at least a week and includes the following symptoms:

-inflated self-esteem or grandiosity

-decreased need for sleep

-more talkative than usual or pressure to keep talking

-flight of ideas or racing thoughts

-distractability

-increased goal-directed activity or psychomotor agitation

-excessive involvement in pleasurable high-risk activities

Definition
manic episode
Term
What disorder has moods and symptoms resembling those in a manic episode but are less impairing, do not require hospitalization, do not include hallucinations or delusions, and have a shorter minimum duration of about 4 days?
Definition
hypomanic episode
Term
What disorder is characterized by a depressed mood and symptoms for most days than not, over at least 2 years and freedom from symptoms that last no more than 2 months at a time?
Definition
dysthymic disorder
Term
What disorder is characterized by numerous periods of hypomanic and depressive symptoms that last at least two years and freedom from symptoms that last no more than 2 months at a time?
Definition
cyclothymic episode
Term
What disorder is characterized by recurrent, unexpected panic attacks, at least one of which has been followed by a month or more of persistent concern about further attacks, worry over their implications or consequences, or a significant change in behavior in relation to the attacks?
Definition
panic disorder
Term
What type of disorder is characterized by an anxiety about being in places or situations where escape may be difficult or embarrassing or help unavailable?
Definition
agoraphobia
Term
What type of disorder is characterized by a marked, persistent, and excessive unreasonable fear that is cued by the presence or anticipation of a specific object or situation, such as dogs, injections, or flying?
Definition
specific phobia
Term
What type of disorder is a marked, persistent fear of one or more social or performance situations that involve exposure to unfamiliar places or to scrutiny by others?
Definition
social phobia
Term
What disorder involves obsessions or compulsions that cause marked anxiety or distress?
Definition
obsessive-compulsive disorder
Term
What disorder is characterized by an event, a fearful response, and the persistent reexperiencing of the traumatic event resemble those in acute stress disorder?
Definition
post-traumatic stress disorder
Term
What disorder lacks a specific traumatic event or focus for concern but is characterized by excessive anxiety and worry, which the person finds hard to control and are about a number of events or activities?
Definition
generalized anxiety disorder
Term
This disorder impairs major functioning, at work or school or in interpersonal relations or self-care and has at least two of the following symptoms for at least 1 month: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms such as flat affect, alogia, avolition; and signs of disturbance must persist for at least 6 months.
Definition
Schizophrenia
Term
This disorder has symptoms similar to those of schizophrenia but they last less than 6 months and the functional impairment seen in schizophrenia need not be present.
Definition
Schizophreniform disorder
Term
This disorder has features of both a major mood disturbance and schizophrenia, and the mood disturbance is present during most of the illness and must, for a time, be concurrent with symptoms of schizophrenia.
Definition
schizoaffective disorder
Term
This disorder is characterized by nonbizarre delusions that involve situations in real life, such as having a disease or being deceived by a lover that persist for at least one month, but the person's functioning is not markedly impaired, and behavior is not obviously odd or bizarre.
Definition
delusional disorder
Term
This disorder is characterized by at least one of the following psychotic symptoms: delusions, hallucinations, disordered speech, grossly disorganized or catatonic behavior that lasts as least one day but less than 1 month, and the person returns to his or her prior functional level?
Definition
brief psychotic disorder
Term
This disorder has prominent hallucinations or delusions may be experienced during a medical illness.
Definition
Psychotic disorder due to a general medical condition
Term
This disorder has prominent hallucinations or delusions may be induced by intoxication or withdrawal from a substance such as alcohol, cocaine, or opioids.
Definition
substance-induced psychotic disorder
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