Term
| what are two statements that describe the two different approaches to understanding anxiety disorders? |
|
Definition
1. anxiety as leading to the development of different discreet problems
2. anxiety as a continuum from normal/mild to dysfunctiona; |
|
|
Term
| in dissociative disorders anxiety is _________ by these 4 things? |
|
Definition
is minimized by:
1.not remembering
2.psychological or physical fleeing
3.psychologically removing the self from the situation.
4. psychologically removing part of the self from the situation. |
|
|
Term
| when feelings of anxiety are avoided by not remembering things about an occurance this is known as: |
|
Definition
|
|
Term
| when feelings of anxiety are avoided by psychological and physical fleeing is known as: |
|
Definition
|
|
Term
| when feelings of anxiety are avoided by psychologically removing the self from the situation, this is known as: |
|
Definition
| Depersonalization disorder |
|
|
Term
| when feelings of anxiety are avoided by Psychologically removing part of the self from the situation, is known as: |
|
Definition
| dissociative identity disorder (multiple personality disorder) |
|
|
Term
| a disorder where one experiences various physical symptoms is known as: |
|
Definition
| somatatization disorder or undifferentiaated somatoform disorder. |
|
|
Term
| a disorder where one experiences a deficit in motor or sensory function is known as: |
|
Definition
|
|
Term
| a disorder where one experiences physical pain is known as: |
|
Definition
|
|
Term
| a disorder where one experiences prepccupation with fears about having a specific disease: |
|
Definition
|
|
Term
| a disorder where one experiences a pre-occupation with a defect in appearance: |
|
Definition
|
|
Term
| who is connected to the statement about anxiety, "alarm to exhausted" that also talked about individual differences in terms of fight and flight: |
|
Definition
|
|
Term
| who was known for the "mild (functional) to panic (dysfunctional) view about anxiety? |
|
Definition
|
|
Term
| Who was known for "the general adaption syndrome" that also referenced allergies and stress? |
|
Definition
|
|
Term
| stress ________ glucocorticoids in the hypotghalamic-pituitary adrenocortical axis(HPA) |
|
Definition
|
|
Term
| stress ________ glucocorticoids in the hypotghalamic-pituitary adrenocortical axis(HPA) and leads to _______ in the dendrites of neurons in the hippocampal region |
|
Definition
increases
leads to atrophy of dendrites |
|
|
Term
| T or false panic attacks only occur with panic disorder |
|
Definition
| false other anxiety disorders such as social phobia, specific phobis, OCD, and GAD and a very high comorbidity with major depressive disorder (50-65% comorbidity) people without mental illness also experience panic attacks at times |
|
|
Term
| t or F to be diagnosed by panic disorder one criteria is that you must have at least 3 unexpected panic attacks |
|
Definition
| False, you must only have had 2 unexpecte3d attacks. |
|
|
Term
| whose work on anxiety disorders proposes that phobias are learned (social learning theory) |
|
Definition
|
|
Term
| what is the phobic stimulus of social phobia? |
|
Definition
| fear of embarrassment or ridicule in social or performancesituations. (or both) fear others will see they are anxious |
|
|
Term
| To be diagnosed with OCD one must have obsessions (recurrent persistant thoughts) and also compulsions (repetitive behaviors)? T or F |
|
Definition
| False. In OCD you may have both obsessions and compulsions, but you also may only have one or the other. |
|
|
Term
| when children experience OCD they may have the symtom of feeling like they are "going crazy" T or F |
|
Definition
| False : although adults experience this awareness, children don't typical have this type of insight yet. |
|
|
Term
| Tourette's disorder has a high comorbitity with : |
|
Definition
|
|
Term
| in children generalized anxiety disorder is known as |
|
Definition
|
|
Term
| Name the 3 subtypes of ptsd and there differences |
|
Definition
1. acute = duration less than 3 mo
2. chronic = duration great than 3 mo
3. delayed onset = at least 6 months have passed since traumatic event |
|
|
Term
| in dissociation a person often experiences a feeling of being outside ones own body and or sense of self is altered (body looks funny or out of proportion) T or F |
|
Definition
False dissociation is when you unconsciously separate and detach emotional significance from an idea or experience. may experience altered state of consciouness or increased sensory input and changes in body chemistry..
.............
the definition given in the question referred to depersonalization, not dissociation |
|
|
Term
|
Definition
| a perception that the external enviroment has changed or become unreal. The individual describes perceptions that indicate objects in the enviro have chnged in size and shape and may think that others may have become unreal. |
|
|
Term
| Post traumatic stress is more common in women. T or F |
|
Definition
| true. the highest rates are of those found among women who are victims of crime especially rape, as well as among torture and concentration camp survivors. |
|
|
Term
| Generic treatment of anxiety disorder includes includes these 2 steps: |
|
Definition
| behavioral treatment and medication |
|
|
Term
| name 2 cognitive haehavioral interventions for anxiety disorders |
|
Definition
1. evaluating apparent cause and effect relationships between thoughts, feelings, and behaviors.
2. implement relatively straightforwardstrategies to lessen symptoms and reduce avoident behavior |
|
|
Term
| Name meds used in the treatment of anxiety disorders 3 |
|
Definition
benzosdiazepines-should taper off after several months of use
......
antidepressants
-buspirone (some success with gad) |
|
|
Term
| define interoceptive training |
|
Definition
| type of conditioning technique used to treat panic disorder which pairs physical changes to relaxation response, recognize early signs of attack |
|
|
Term
| name 2 meds usually prescribed for social phobia |
|
Definition
| paroxetine (paxil), and fluvoxamine (luvox) |
|
|
Term
|
Definition
clomipramine (a TCA)
and all SSRI's (usually higher doses than for other anxiety disorders, harder to treat) |
|
|
Term
| whi iw known for the development of three principal components of PTSD |
|
Definition
|
|
Term
| In the inpatient setting one should treat PTSP by uncovering issues surrounding trauma history, T or F |
|
Definition
| F, coming to terms with trauma should be saved for outpt treatment after the pt is stablized. |
|
|
Term
| the inpatient treatment of PTSD includes these 5 things. The goal of this treatment is? |
|
Definition
treatment includes:
1. avoid digging into trauma history
2.assess triggers for flashbacks
3. grounding (teach techniques) (ie sleep next to wall at night, touching it brings one back to reality (here and now) during night terror)
4. milieu issues, decrease stimulation, and exposure to triggers.
5.therapeutic relationship, build trust decrease blame guilt and self esteem issues.
the goal of inpatient treatment is the containment of symptoms. |
|
|
Term
| what is the goal of outpt treatment of PTSD |
|
Definition
| increased insight into self and symptom self-self management |
|
|
Term
| onset of ptsd is usually about ____ to _____ after the traumatic event |
|
Definition
|
|
Term
| according to Kluft what are the criteria related to DID that MUST ALL be present to develop the disorder? |
|
Definition
1.ability to dissociate (as evidenced by hypnotizability)
2. trauma (typically horrible childhood abuse)
3.substrates (things that facilitate dissociation) such as role play dungeons and dragons pretending to be someone else, abuser pretends abuse happended to someone else.
.insufficient soothing or processing of trauma, person does not have someone to talk to basically,,,they never received any form of counseling or support from adult after the trauma. |
|
|
Term
| treatment for DID includes beginging to elicit alters ... T or F |
|
Definition
| False, research shows this results in deterioration in functioning (although the alters may present themselves without eliciting them) |
|
|
Term
| what is the goal of outpatient treatment for DID |
|
Definition
| integration or increased awareness of trauma and other memories and all parts of personality. |
|
|
Term
|
Definition
| a release of emotion after recalling painful events that were repressed. often associated with DID as personalities are integrated and born personality experiences the trauma for the first time as his/her whole self. |
|
|
Term
how do you treat acute somatiform disorder symptoms
how about if chronic? |
|
Definition
tylenol, NSAIDS and opiods (treat the pain)
-chronic: treatment of depression even if purely physiological treat with pain management, comfort, autogenic training, self hypnosis, therapy (like for OCD or phobia) |
|
|
Term
| which personality disorder is characterized by a strong ID and superego, but a weak ego |
|
Definition
| borderline, imulsive and self critical |
|
|
Term
| which personality disorder is characterized by a strong ID and a weak superego- |
|
Definition
| anti-socialm impulsivem hedonistic (pleasure seeking), no self criticism, by any means necessary to get what they want without regard to others. |
|
|
Term
| which personality disorder is characterized by a weak superego and ego |
|
Definition
| schizoid relationships lack warmth, needs/drives met through fantasy |
|
|
Term
| name 3 core features of borderline PD as characterized by masterson |
|
Definition
1. intense unstable relationships
2. unstable moods
3. ambivalence (want intimacy but afraid will lead to rejection later) |
|
|
Term
| name lenehans 3 bimodal behavioral patterns |
|
Definition
1. emotional vulnerability vs invalidation( can't regulate emotion, emotions had never been vaidated... I feel pain, "No you don't")
2. helplessness vs apparent competancy (looks competant but has difficulty problem solving)
3. unrelenting crisis vs inhibited grieving. (constantly overwhelmed and amidst crisis and therefore can't grieave or successfully resolve loss, dissappointment and trauma) |
|
|
Term
| masterson is responsible for this theory on borderline personality |
|
Definition
| attachment theory, learning theory and systems theory |
|
|
Term
| matersons attachment theory of attachment, learning, and systems focuses on these 4 symptoms of borderline personality disorder |
|
Definition
1. poorly developed ego with primitive defense mechanisms (slitting, idealization, devaluation, acting out)
2. introjection of only part of maternal object. don't have a complete representation of mom (all good or all bad) mom + me = self
3. problems w. attachments to others and huge fear of rejection
4. rage and anger at self and others |
|
|
Term
| Moffit's theory on anti-soc PD states these 4 developmental/ behavioral characteristics among those effected |
|
Definition
1. subclinical abnormality like verbal processing problem, or ADDH
2.negative responses of others in combination nwith their addh or verbal processing probs.
3. become ensnaredd in consequences of anti soc behavior and expect rejection from othes.
4. problematic behaviors common across personality disorders (acting out, splitting, regression, unhealthy relationships) |
|
|
Term
| what is the main nursing intervention for acting out and manipulation |
|
Definition
|
|
Term
| Top 2 nursing interventions when working with borderline personality disorder |
|
Definition
1. recognize that impulsive and destructive behviors are responses to affect and that they can be changed over time.
2. assist pt in identifying specific techniques that might help control impulses and modify responses. |
|
|
Term
| what is the main nursing intervention used as primary prevention for antisocial personality disoder |
|
Definition
prevent the subclinical neurophysiological abnormality
-good preinatal environment and care
- good post natal nutrition and decreased stimulation. |
|
|
Term
| what is the best nursing intervention to use for secondary prevention related to antisocial personality disorder |
|
Definition
| -work with behaviro that is a challenge for families, use firm limit setting. |
|
|
Term
what risk factors make carrying out interventions for secondary prevention of antisocial PD very difficult.
3 risk factors |
|
Definition
1. poverty
2, racism
3. agressive, violent family environment |
|
|
Term
| what is the best nursing intervention in response to splitting (staff member is all good or all bad) |
|
Definition
1. treamtment team meetings and joint decision making ( no one person is the bad or the good one)
(also get clinical supervision (these pt can cause counter transference in staff! also use contracts for behaviors and have pt sign it) |
|
|
Term
| what are the top 2 nursing interventions for regression |
|
Definition
1. identify whats causing the anxiety and try to reduce this by manipulating the enviroment.
2, tolerate dependency but REWARD indepent behaviors and attempts at independance |
|
|
Term
| masterson's learning theory suggests that if you allow a pts dependancy on you to make you withdraw due to frustration or discust or fear of manipulation, you will be acting AS a __________ ___________ for that dependency... this will cause the pt _______ |
|
Definition
as a "negative reinforment" (remember reinforing always increases the behavior even if its negative reinforcement!)
this will cause the pt anxiety and regression. |
|
|
Term
| acoording to mauler, expectation of environment leads to: |
|
Definition
|
|
Term
| according to mauler safe secure environment for personality disorders leads to |
|
Definition
| depression and acting out |
|
|
Term
| according to mauler for personality disorders, fear of abandonment leads to |
|
Definition
|
|
Term
| what is the nursing diagnosis for persons with personality or character disorders? |
|
Definition
| alterations in psychosocial adaptation |
|
|
Term
| name 3 common/top nursing diagnosis for borderline personality disorder |
|
Definition
1. risk for self mutilation
2. dysfunctional grieving
3. impaired social interaction |
|
|
Term
| name the top 2 nursing diagnosis for antisocial personality disorder |
|
Definition
risk for other directed vioence (rage reactions can't tolerate frustration)
defensive coping (disregard for societal norms and laws, absence of guilt, inability to delay gratification) |
|
|
Term
|
Definition
| a primitive defense mechanism in which the client sees objects as all good or all bad |
|
|
Term
| according to mahler predisposition to borderline personality disorder occurs when developmental tasks go unfufilled in which phase? |
|
Definition
| the rapprochement phase, at this time the mother withdrawas emotional support in response to the childs increasing independence. exp the child wants to start being independant (a little bit) but wants to be able to "check in" with parent (look back make sure they are still there for them) but parent does not provide this "emotional refueling" |
|
|
Term
| milieu therapy is a good choice for clients with antisocial personality disorder because it: |
|
Definition
| emulates a social community in which the client may learn to live harmoniously with others |
|
|
Term
| who is responsible for the theory of object relations |
|
Definition
|
|
Term
| Bulemia nervosa's onset is in early adoscence. T or F |
|
Definition
| False. the onselt is in late adolescence early adulthood. |
|
|
Term
| name 3 characteristics in the female athlete triad |
|
Definition
1.disordered eating.
2. amenorhea
3. osteoporosis. |
|
|
Term
| name the phsyiological features/consquences of anorexia |
|
Definition
-increased efficiency of metabolism
-inc energy conservation (slowed HR, hypotensive edema secondary to hypovolemia, hyperaldosteronism low albumin)
-shift in body energy to conserve vital organ function, dec body fat, irreg menses, loss of breast tissue, osteoporosis, loss of har, growth of lanugo, low muscle mass, starved brain can lead to psych symptoms. |
|
|
Term
| name the biologial features/consquences or bulemia |
|
Definition
-loss of teeth enammel, -esophageal erosion, -sores or callouses on hand, -swollen parotid glads, -risk or gastric rupture, hiatus hernia
-dec K which leads to EKG changes and hypokalemic alkalosis
diueretic dependance, fluid retention/ dehyration
laxative dependence
constipation/dehydration
Ipecac syrup use can lead to cardiac and skeletal myopathies. |
|
|
Term
| 3 nursing interventions for people with eating disorders |
|
Definition
1. reality testing- challenge body image
2. increase sense of efficacy- support or promote initiative
3. increase awareness of true internal state but if starved may not be physically or psychologically possible. |
|
|
Term
| whatare 2 nursing interventions to the sociological effects of ED's on a culture |
|
Definition
1. prevention = promote social change
2. for ill individuals don't directly change the culture challege the techniques used to lose or manage weight, and identify other aspects of self that are indicators of success. |
|
|
Term
nursing interventions for eating disorders
name 4 |
|
Definition
-social learning-get new role models teach better coping skills
-operant conditioning-exstinguish freq of ED behavior. reduce stress, don't give attention for problem behaviors.
-reinforce new more adaptive behavior, use social rewards, inc priviledges
-substitute new behavior for dysfunctional one |
|
|
Term
|
Definition
| weight in kg/ht in meters squared |
|
|
Term
| what is the goal of inpt treatment of eating disorders |
|
Definition
weight gain 2-3 lb per week
and normalizing eating |
|
|
Term
when does amphetamine w/d take place?
when does it peak
name 2 longer term effects of withdrawal |
|
Definition
occurs within 3 days peaks in 2-4 days.
-sleep disturbance (weeks)
-depression and irritability (suicide risk) |
|
|
Term
| what neurotransmitter depletes with long term cocain use |
|
Definition
|
|
Term
| depletion of norepinephrin in long term cocaine use results in a ________ state during withdrawal where the person may sleep 12-18 hours |
|
Definition
|
|
Term
how long can cocaine withdrawal symptoms last?
what are two mental withdrawal effects |
|
Definition
24hours
paranoid and suicidal thoughts can occur; suicide risk |
|
|
Term
| Benzo withdrawal symptoms may begin to emerge up to __ days after stopping a long acting benzo (long half life) |
|
Definition
|
|
Term
| benzo withdrawal is known for symptoms such as |
|
Definition
| seizures and toxic psychosis (hallucinations worse at night) |
|
|
Term
| pts who are withdrawing from both alcohol and benzos often seem to be improving from alcohol withdrawal just as ______________________________. |
|
Definition
|
|
Term
barbituate withdrawal occurs _____ to _____ after dec or cessation of use
is similar to withdrawal from ________ only more severe |
|
Definition
hours to several days
similar to benzo withdrawal |
|
|
Term
what is bupinorphin used for, how does it work, what route
what makes this drug have a low potential for abuse |
|
Definition
treatment for opiod dependancy acts as a mu agonist and antagonist, taken Sub-lingually.
the drug does not have agonist effect if used IV which makes abuse low |
|
|
Term
| what is buprenorphine used for? what is route |
|
Definition
used for opiate adiction,, SL
- |
|
|
Term
what is levomethadyl (LAAM) used for:
what is its mechanism |
|
Definition
used for opiate withdrawal
mechanism is mu-opioid agonist
longer duration of action 3x a week dosing
lower level of physical dependance
low abuse potential |
|
|
Term
| what drugs are used to treat alcohol? |
|
Definition
| thiamine, anticonvulsant (dilantin) and gradually reduced doses of librium or valium. |
|
|
Term
| how do you treat cocaine addiction with meds |
|
Definition
antidepressants - prozac and desipramine (norpramin/parnate) for da effects, decreases craving
amd trazadone (sleep)
Bromocriptine has rapid anti-craving action, flupenthixol. |
|
|
Term
| what is disulfiram what is it used for and why |
|
Definition
| used for alcohol addiction ...interferes with alcohol metab and causes distressing reaction to consumed alcohol. |
|
|
Term
| what is naltrexone used for |
|
Definition
| can be used for narcotic addiction it is a narcotic antagonist and blocks response to narcotics by binding to the receptos so the person gets no euphoria from consumed narcotics, but won't get sick if they do. |
|
|
Term
define wernike encephalopathy syndrome?
what causes it |
|
Definition
alcohol induced presistant amnesic disorder acute onset and resolves.
caused by thiamine deficifiency |
|
|
Term
| what is korsekofs syndrome what causes it |
|
Definition
| is an alcohol induced amnesic disorder similar to wernickes encephalopathy syndrome only 20% recover from this. it causes permanent memory issues and brain damage... person often confabulates |
|
|
Term
what is precontemplation
-interventions 3 |
|
Definition
no interest in changing drinking behavior
-express concern
-show them abnormal lab values
-ask questions like how would you know if your drinking was a problem for you |
|
|
Term
define contemplation
-3 nurse interventions |
|
Definition
pt is ambivalent about changing drinking, he can describe benefits of abstinance and barriers to this.
-support perceptions of the benefits
-discuss possible solitions to barriers one at a time
-offer suggestions about solutions that have been effective for others. |
|
|
Term
define preparation
-3 nurse interventions |
|
Definition
ready to change drinking, they have already decreased drinking.
-support even the smallest efforts
-help the pt focus on approaches that have been successful for him
-encourage support such as alcoholics anonymous or rational recovery |
|
|
Term
define action (related to stages of change)
-2 nursing diagnosis |
|
Definition
actively engages in change and abstinance form alcohol is achieved
-reframe problems as opportunities for growth
-encourage continuing particupatrion in support groups. |
|
|
Term
define maintenance ( in relation to the stages of change)
-3 nursing diagnosis |
|
Definition
pt efforts aimed at incorporating sobriety into their life.
-ask them to identify strategies that have helped
-help with problem solving strategies
-encourage continued participation in support groups. |
|
|
Term
define relapse
s
-3 nursing interventions |
|
Definition
negative thoughts and emotions lead to a return to drinking
-help the pt deal w his sense of failure by pointing out accomplishments made during abstinance, such as improved relations with family
-discuss the episode as a normal part of the process.
-help the pt identify stratedies to prevent further relapse. |
|
|
Term
| what does goodness of fit refer to |
|
Definition
| the traits of the child are complemented by the traits of the parent so that the childs needs are met "just right" not too much or too little of anything.. this is different for every child mother pairing, if messed up needs will not be fufilled correctly...results in problems later |
|
|
Term
| what did kagans work on temperment show about children and mental illness 2 things |
|
Definition
-approach /seek out the unfamiliar --> inc risk for conduct disorder
-avoidance of the unfamililiar --> anxiety disorder |
|
|
Term
| WHAT DID Friedrich say about childhood agression and sexualizing behaviors |
|
Definition
| children are developing aggressive tendencies when exposure to a sexualized enviro provides a sexual channel for the aggressive behaviors paired associate learning: pleasure paired with agression. |
|
|
Term
| what did johnson and feldmeth say about sexualized behavior in kids |
|
Definition
four group continuum:
1 need limits kknowledge
2 need intervention for group 1 plus therapy
(next two usually in care of state or residential foster or group settings need all of the above interventions plus special ones)
3. sexual behaviors are a way of coping exhibit blase effect when caught
4. impulsive aggressive compulsive sexual behaviors motivated by need to reduce negative feelings, they are agressive when caught. recognize and stop behaviors |
|
|
Term
| name 4 special mental health issues for adolescents |
|
Definition
1. suicide, (depression give away possessions)
2. violence homicide or lethal violence is second leading cause of death in this age group.
3. substance abuse
4. drug facilitated sexual assault with -Rohypnol "roofies",
- alcohol,
-GHB a cns sedative called liquid exstacy get first urine specimin! can have other have other uses that are helpful |
|
|
Term
| Name the 2 goals of play therapy |
|
Definition
carthasis -release of strong emotion to relieve inner tension
-abreaction-reliving through play of past events and related feelings so child can gain mastery over an experience in which she had no control. |
|
|
Term
| Procedures used in play therapy |
|
Definition
use of limits
supplying materials that allow varying degrees of expression |
|
|
Term
| differnce of child onset MDD to adult MDD |
|
Definition
| associated with more perinatal insults and motor skill deficits, caretaker instability, criminality and psychopathology in family of origin and behavioral and emotional problems... school absences! |
|
|
Term
| what test is used to screen and assess response to stimulant meds |
|
Definition
| OPTAX optical tracking and attention test. |
|
|
Term
| alpha adrenergicblockers like clonidine are sometimes used to treat ADD/ADHD in kids t or f |
|
Definition
|
|
Term
| name 4 types of treatment drugs used to treat add/adhd |
|
Definition
stimulants
alpha adrenergic blockers
ssri's (stop if disinhibition occurs)
bupropion (wellbutrin) weak reuptake blocker
atomoxetine/ strattera(tomoxetine) new blocks norepinerphrine.. liver damage? |
|
|
Term
| 2 drugs used to treat enuresis |
|
Definition
imipramine a tricyclic
and
DDVAP synthetic antidiuretic hormone that decreases urine production. |
|
|
