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Psychiatry > Feb. 17 > Flashcards

Feb. 17 Flashcards

1
Q

Mental Disorder

A

-syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning

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2
Q

Trauma-and Stressor-Related Disorders

A
  • adjustment disorders
  • bereavement
  • demoralization
  • PTSD
  • Acute Stress Disorder
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3
Q

Intellectual Development

A

-Piaget

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4
Q

Psychosexual Development

A

-Freud

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5
Q

Psychosocial Development

A

-Erickson

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6
Q

Moral Development

A

-Kohlberg

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7
Q

Resiliency Protective Factors

A

-some people are more resilient than others
-Protective Factors:
supportive, cohesive family environment
external support systems (school, relatives)
intelligence
hardiness (strong genetic endowment)
autonomy (risk-taking with safety net)
positive social oriientation
(people growing up in chaos are at a distinct disadvantage)

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8
Q

Stress

A

-prime cause, or contributing factor, for many diseases, including mental illness

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9
Q

Impact of Stress

A
  • stress, performance, & learning (Yerkes-Dodson Law): What is it?
  • Bio-Behaviorla Mechanisms of the Stress Response
  • Effect of Stress on Bodily Processes
  • Psychological Consequences of Stress
  • Holmes-Rahe Life Events Scale
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10
Q

Adjustment Disorder

A
  • emotional or behavioral symptoms in response to an identifiable stressor, occurring within 3 months of the onset of the stressor
  • marked distress and/or significant impairment
  • when stress is gone, symptoms don’t linger more than 6 months
  • not due to another mental disorder
  • not due to normal bereavement
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11
Q

Bereavement & Grief

A
  • can take many, often dramatic, emotional forms & persist for a long time, not a mental disorder, but it can morph into major depression
  • suicidal intent, marked self-neglect, persistent feelings of worthlessness & intense unreasonable guilt are not considered “normal bereavement/grief”
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12
Q

Acute Stress Disorder

A
  • symptoms are precipitated by an acute stress or trauma
  • start no later than 3 days after the trauma, last up to 1 month, cause distress & impairment
  • common in first responders & victims of disaster
  • intrusive thoughts, intense anxiety, or other emotional response, including angry outbursts
  • involves nightmares, flashbacks, and re-living the event
  • guilt is not uncommon, neither are panic attacks, impaired memory & post-concussive symptoms
  • trauma experience may be direct or vicarious
  • symptoms must persist for at least 3 days after traumatic event, & must not last longer than 1 month
  • not related solely to seeing the event on TV or electronic media, unless that exposure or coverage was connected to the job itself
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13
Q

Post-Traumatic Stress Disorder

A
  • Arousal: sleep problems, startle, irritability, self destructive behavior, poor concentration, hypervigilance
  • Intrusion: nightmares, flashbacks, forced recollection, physiologic reactivity
  • Avoidance: internal (memories) or external (cues, reminders)
  • Negative emotional & cognitive change: Amnesia, negative beliefs (I’m bad, everyone bad, world unsafe); guilt, fear, anger, shame, loss of interest, detachment/estrangement; lack of positive emotion)
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14
Q

PTSD Prevalence

A
  • 8.7% lifetime adults, 3.5% one year prevalence
  • medically relevant when participating in relief operations, emergency or urgent care; follow up with trauma patients, burn patients, rape victims sexual disorders, behavior disorders
  • affects sick role behavior, causes disability
  • requires sensitivity “trauma informed care”
  • invasive medical procedures can exacerbate PTSD (re-kindle traumatic memories)
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15
Q

Trauma-Informed Care?

A
  • survivor’s needs to be respected, informed, connected, & hopeful
  • staying calm, not being upset along with the patient
  • interrelation b/w trauma & symptoms of trauma (substance abuse, eating disorders, depression, anxiety)
  • work in collaborative way with survivors, family & friends of the survivor, & other human services agencies, empowering survivors
  • see the world through patients eyes
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16
Q

How to confirm a diagnosis?

A
  • right person? (age, sex, developmental stage)
  • symptom and course constellation
  • backstory (typical developmental history)?
  • family history
  • response to past or current treatment?
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17
Q

Mental Status Examination

A

-patient’s appearance, motor activity, mood and affect, speech & language, thought form & content, perception, capacity for insight & judgement, & cognitive functioning

18
Q

Mood

A
  • sustained subjective emotional state as reported by the patient
  • mood that correlates with limbic system function are most affected in psychiatric disorders (euphoria/excitement, sadness, worry/fear, anger, disgust)
19
Q

Affect

A

-an observed emotional state, more immediate & transitory than mood

20
Q

Tangentiality

A

-wandering from a topic

21
Q

Circumstantiality

A

-providing excessive detail

22
Q

“flight of ideas”

A

-rapid jumps from one idea to the next

23
Q

“derailment”

A

-complete lack of logical connectedness

24
Q

Clanging

A

-linking words with sounds rather than meanings

25
Q

Neologisms

A

-creating new words

26
Q

Blocking

A

-going blank

27
Q

Perseveration

A

-the inability to move from one idea to the next

28
Q

Rumination

A

-preoccupation with distressing thoughts (seen in depression & anxiety)

29
Q

Obsessions

A

-unwanted concerns, ideas, images, or impulses intruding into consciousness

30
Q

Delusions

A
  • false beliefs foreign to the individual’s sociocultural or religious background that persist despite evidence to the contrary
  • may be fixed (unshakeable & consistently present)
  • or fluctuating (changing in response to circumstances)
    also: mood congruent or incongruent, plausible or bizarre
31
Q

Illusions

A

-perceptions that are misinterpreted

32
Q

Hallucinations

A

-sensory experiences that occur without external stimulation

33
Q

Delirium

A

-Cardinal sign: fluctuating level of consciousness

34
Q

Folstein Mini Mental State Examination

A

-bedside test of cognition

35
Q

Risk Assessment

A

-question patients about feelings, attitudes, ideas, motives, & intentions to harm self/others

36
Q

Case Formulation

A

-concise summary of biological, psychological, & social factors that account for the patient’s development of a clinical psychiatric disorder and provides basis for decisions about treatment

37
Q

Adjustment Disorder

A
  • reactions to identifiable stressor event or situation
  • occur within 3 months
  • chronic forms last >6 months
  • symptoms in response to events not intrinsically traumatic or who respond to trauma with symptoms other than those of a PTSD
38
Q

Resilience

A

-good general heath, adequate social resources, and the psychological qualities of sociability, humor, flexibility of thought, perseverance, emotional self awareness, and internal locus of control in face of stress

39
Q

Complicated Grief

A

(pathological)

  • may have lasting effects on survivor’s overall adaptation
  • severe reaction of grief
  • loss of child, parent early on, spouse in mid-life, sudden loss (disaster, suicide, violence, accident)
40
Q

Typical qualities of Grief?

A
  • preoccupation with the loss, searching for the person, sadness, guilt, anger, despair, anxiety, desire for comfort or consolation from others coupled with alone time, difficulty concentrating, anorexia, restlessness, poor sleep
  • hearing or seeing lost person is not uncommon
  • come in waves & may recur unexpectedly when some person or event triggers memory
41
Q

Signs of Complicated Grief

A
  • intense guilt
  • prolonged anhedonia
  • inability to find any meaning in life
  • suicidal ideation
    (inc. use of drugs or alcohol is an intrinsically maladaptive response to grief that can have serious consequences)
42
Q

Demoralization

A
  • form of patterned maladaptation in circumstances that overwhelm normal coping
  • people feel trapped, experience subjective incompetence, and believe they can’t master what troubles them

Psychiatry (7 decks)

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