Shared Flashcard Set

Details

Behavioral Emotions
Behavioral Emotions
47
Medical
Graduate
05/10/2010

Additional Medical Flashcards

 


 

Cards

Term
Elevated mood
Definition
air of confidence and enjoyment; a mood more cheerful than usual.
Term
Elation
Definition
feelings of joy, triumph, intense self-satisfaction, or optimism
Term
Expansive mood
Definition
expression of feelings without restraint with an overestimation of their importance
Term
Ecstasy
Definition
feeling of intense rapture
Term
Euphoria
Definition
intense elation with feelings of grandeur.
Term
Irritable mood
Definition
easily annoyed and provoked to anger
Term
Depression
Definition
psychopathological feeling of sadness.
Term
Anhedonia
Definition
loss of interest in and withdrawal from all pleasurable activities, often associated with depression.
Term
Grief
Definition
sadness appropriate to a real loss.
Term
Suicidal ideation
Definition
thoughts of taking one's own life.
Term
Alexithymia
Definition

a person's difficulty in describing or being aware of emotions.

Term
Affect
Definition

“Normal” appropriate= a broad range of affect
i.e. when discussing something unhappy the individual appears sad and laughs when things are funny

Term

Affect

Inappropriate

Definition
disharmony between emotional feeling tone, idea,  thought, or speech  accompanying it
Term
Blunted
Definition
severe reduction in the intensity of external tone of feeling
Term
Labile
Definition
rapid and abrupt changes in emotional tone that is unrelated to external stimuli
Term
Flat
Definition
appears void of emotion
Term
Look for “appropriateness” of emotions based on the subject matter being discussed.
Definition

Discussing the recent death of a child with cheerfulness or smiles
Discussing a recent promotion with sadness and anger
Discussing a children’s movie they recently saw with intense fear and apprehension

Term
Biological Indicators that can alter expressed affect
Definition

Ask about psychophysiological changes
Diurnal variation of mood
Changes in sleep
Changes in appetite and weight
Changes in libido

Term
Thought Process (Form)
Definition

Continuity of Thought
The extent to which a person’s thoughts are goal directed.
Disturbances are thought to be caused by:
Pathological disorders (e.g. Schizophrenia, head injury)
If not pathological in nature examine if they are due to limited intelligence, culture factors or a severe reaction to overwhelming negative emotional states

Term

Continuity of Thought (measured by speech)

Definition

Clang associations – connected illogically by rhyming or puns

Echolalia – person repeats what you say (copy cat)

Neologisms – invented or condensed words that have meaning only to the the patient (quantrum)

Perseverations – involuntarily responding to all questions in the same way

Word salad – nonsense  words and phrases

Looseness of associations – jumps from one topic to another, the connection between the topics is lost

Blocking – sudden lapse of thought mid sentence without recovery of train of thought

Circumstanitiality – absence of direction toward a goal of thought.  Very detail oriented, they get stuck but do come to a conclusion

Tangentiality – severe circumstantiality  where the individual strays completely from the topic and includes thoughts seem to be totally unrelated or irrelevant (Seen in Schizophrenia most commonly)

Term
Thought Content
Definition

Reveals how connected, coherent, and logical the patient's thoughts are.


Term
Delusions
Definition
deep seated false belief despite objective contradictory evidence
Term
Religious
Definition
(false belief that the person has a special link with God)
Term
Delusional Thinking
Definition

Don’t Challenge the Delusions but evaluate them.
Evaluate:
Severity
Fixedness
Elaborateness
Power to influence the patient
Deviation from normal  (Bizarre vs. Non-Bizarre)

Term
Thought Content
Definition

Suicidal and/or Homicidal Ideation
Preoccupations (e.g., with illness or symptoms).
Obsessions (repetitive, and intrusive thoughts, images, or impulses)
Compulsions (repetitive and intrusive actions)
Phobias (excessive and irrational fears)
Paranoia
Ideas of reference and influence
Poverty of Content (lack of words)


Term
Suicidal Thoughts
Definition

Always ask about suicidal thoughts especially if there is any sign of depression


In a Mental Status Exam:  Always ask about any history of suicidal thoughts and record the response in your write-up:

Pt denied current suicidal ideation.”

“Pt. stated no history of suicidal ideation”


“Have you ever thought of hurting yourself or other people? Why are you no longer suicidal and what has changed?”

Term

Follow-up on all potential suicidal thoughts.

Create a “contract”  with the patient

Definition

-Hospitalize if the patient is unable or unwilling to follow-up or create a “contract”.

Keep following up.

-Attempt to help the patient change the hopeless/helpless ideation about their life.

Term
Format for write-up of Thought
Definition
evaluation of suicidal and/or homicidal thoughts, gestures or actions.
Term
Perceptual Disturbances
Definition

Abnormal sensory functioning
Hallucinations  - sensory impression with no external stimulus
**Auditory (most common in psychosis)**
**Visual (most common in medical disorders)**
Tactile (haptic) - touch
Gustatory – taste
Olfactory - smell
Vestibular sense – feels like flying
Hallucinosis – associated with chronic alcohol abuse and that occur within a clear sensorium, as opposed to delirium tremens (DTs), hallucinations that occur in the context of a clouded sensorium.
Hallucinations can also occur when falling asleep (hypnogogic) or when awaking (hypnopompic). (these are generally nonpathological).

Hypnogogic: feel like you’re falling when you’re falling asleep.


Term
Perceptual Disturbances
Definition

 

Illusions – misrepresentation of real stimuli (thinking a stranger is someone you know until they get closer).
Depersonalization – loss of reality of the self (the persons feels they are different). See yourself outside your body.
Derealization – the person feels their environment has changed and that external reality is no longer familiar. Take off your glasses, your world is a little fuzzier. Usually temporary.

 

Term

Format for write-up

of Perception

Definition

Perceptual Alterations:  Record hallucinations in any of the six sensory spheres (auditory, visual, olfactory, gustatory, tactile and somatosensory) being aware of possible neurologic and physical etiologies.  Document any illusions, depersonalization or dissociation currently or recently.


Perceptional disturbance.

-”Do you see or hear things that other people don’t see or hear”.

-”I’m glad you don’t hear and see things other people don’t".

Term

Format for write-up

of Judgment

Definition

Judgment:  Evaluate and document the level of judgment (i.e. poor to excellent or critical, automatic, impaired).

Term
Insight
Definition
the capacity to understand that there is a problem, to think about how it came about.
Term
Levels of Insight
Definition

 

1. Complete denial of illness


2.  Slight awareness of being sick and needing help but denying it at the same time.

Awareness of being sick but blaming it on others, on external   factors, or on organic factors.
Awareness that illness is due to something unknown in the   patient.
Intellectual insight: admission that the patient is ill and that   symptoms or failures in social adjustment are due to the   patient's own particular irrational feelings or disturbances   without applying this knowledge to future experiences.
True emotional insight: emotional awareness of the motives   and feelings within the patient and the important people in   his or her life, which can lead to basic changes in   behavior.

Term
Format for write-up of Insight
Definition

Insight:  Document the individuals understanding of their illness, it’s severity and seriousness, it’s treatment and their need for therapeutic interventions, and any other special circumstances such as criminal charges, conservatorships, etc. Use the appropriate label for the person’s level of insight. 

Term
Physical Examination:
Appearance and Behavior
Definition

Describe the individual so that anyone who is reading your report will understand what they looked like during the interview:
Record overall physical appearance
How old does the patient look? Older or younger their stated age
Grooming – are they appropriately dressed, clean?
Note eye contact or lack of eye contact

Term
Appearance and Behavior
Definition

Level of consciousness – How alert is the patient during the interview
This is especially important in psychiatric and hospital settings and will dictate the presentation of their mental functioning
Described on a continuum from comatose to alert.
Comatose, Stupor, Lethargy, Drowsy, Alert

Term
Level of consciousness
Definition

How alert is the patient during the interview


Described on a continuum from comatose to alert.
Comatose, Stupor, Lethargy, Drowsy, Alert

Term
Consciousness (5 broad levels)
Definition

1. Coma – no verbal or motor responses in response to noxious stimuli
2. Stupor – individuals required repeated stimulation to be roused
3. Lethargy individuals are sleepy, and indifferent.  They respond in a manner which is incomplete and delayed
4. Drowsy individuals who are sleepy but can be roused by aversive stimuli
5. Alert – wakefulness.  Individuals respond promptly and appropriately.

Term
Consciousness
Definition

1. Disorientation – disturbance of orientation in time, place or person
2. Clouding of consciousness – incomplete clear-mindedness with disturbances in perception and attitudes
•3. Delirium – restless, confused, disoriented associated with fear and hallucinations
4. Coma  vigil – patient appears to be asleep but ready to be aroused (AKA akinetic mutism)
5. Twilight state disturbed consciousness with hallucinations
6. Dreamlike state -  often used as a synonym for complex partial seizure or psychomotor epilepsy
7. Somnolence – abnormal drowsiness
8. Confusion – involves in appropriate reactions to environmental stimuli; manifested by disordered orientation
9. Sundowning – syndrome in older persons that usually occurs at night and may consist of confusion, drowsiness, ataxia  and falling (usually associated with overly sedative medications)

Term

If consciousness is impaired what does it tell us? 

Definition

Mild impairment observed in individuals with unilateral cortical or thalamic lesions
Severe impairment in individuals with damage to the brainstem or bilateral lesions of the thalami or cerebral hemispheres
Toxic or metabolic factors also common causes of impairment

Term
Physical Examination
Definition

Record a description of the person’s appearance including but not limited to their general height, weight, body type, neatness, cleanliness, manner of dress and whether they appear their stated age.  Also note the person’s level of consciousness.

Term

Assessment Areas of Cognition

Mini Mental State (Status) Examination

Mini Mental State (Status)  Examination

Definition

1. Level of Consciousness
2. Orientation
3. Attention and Concentration
4. Registration of information
5. Memory
6. Language
7. Visuo-spatial abilities

Term
Cognitive Evaluation
Definition

Assessment of certain functions is critically dependent on the integrity of other functions.

Critical Skills

1. Level of consciousness and attention
2. Memory: immediate, short and long term
3. Language: naming, fluency, repetition

4. Visuospatial Skills: construction abilities
5. Executive Skills: abstraction

Term
Sensorium
Definition
the areas of the brain that process and register incoming sensory information and make possible the conscious awareness of the world.
Term
Sensorium and Cognition
Definition

The “normal” patient is alert, oriented, aware, and able to cooperate and sustain attention through out the interview.
Clear and Cloudy.

Term
Mini Mental State Examination (MMSE)
Definition

Empirically validated screening tool (widely used)
Score of 0-30 possible
Normal
Mild impairment
Moderate impairment
Severe impairment
This measure does not DIAGNOSE !! (distinguish the nature of an illness through medical analysis).
Good test-retest reliability

Supporting users have an ad free experience!