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Behavioral Medicine > Introductory Lecture > Flashcards

Introductory Lecture Flashcards

1
Q

mental disorder

A

clinically significant behavior or psychological syndrome. Occurs w/stress or disability. Inc. risk of death, pain, or loss of freedom.

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2
Q

legal definition of mental illness

A

whether or not @ the time of the act the individual knew the difference between right and wrong.

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3
Q

categorical classification system

A
  • divides classifications based on criteria sets

- Provisional-think it is this type, but not sure

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4
Q

hallucinations in schizophrenia

A

in schizophrenia most commonly auditory running commentary

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5
Q

delusions

A

-firmly held untrue belief that are not susceptible to rational argument/contravening evidence

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6
Q

bizarre dilusions

A

cannot be true. EX. Space aliens are controlling my thoughts.

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7
Q

polythetic criteria sets

A
  • meet diagnostic criteria in different ways
  • don’t need every symptom that is listed
  • can have different symptoms presentation
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8
Q

Axis 1

A

-cannot be induced by substance
-cannot be better accounted for by medical condition
Ex. schizophrenia/major depression
-Clinical Conditions-must be severe enough to cause a person significant distress or impair functioning
-most axis I conditions-run as stress diathesis model
eg. You have genetic or built in predisposition to illness and environmental load
Ex. Schizophrenia-monozygotic twins (identical genetic load) only have 48% accordance rate for schizophrenia-very genetic
Ex. Schizophrenia twins in same environment- 78% chance that twin w/ schizophrenia will be low birth weight twin.

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9
Q

Axis 2

A
  • mental retardation or personality disorders commonality between these are intrinsic to the person
  • Cannot be cured like phobias or OCD
  • Fxn can be improved but not cured
  • personality disorder must be present by early adolescents or early adulthood-stable features do not come and go
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10
Q

Personality

A

-reality stable pattern of understanding self, others, interacting w/environment

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11
Q

Axis 3

A
  • General medical conditions that we believe may contribute to the presentation of Axis I disorder
  • Ex. dementia (Axis I) associated w/Alzheimer’s disease (Axis III)
  • Alzheimer’s is the medical condition and behavioral or psychiatric syndrome induced by Alzheimer’s disease is Axis I disorder-dementia
  • Ex. Axis I disorder major depression illness and Axis III is hyperthyroidism
  • Ex. Axis I generalized anxiety disorder and Axis III is chronic obstructive pulmonary disease
  • Axis III disorder is contributive to or exacerbates Axis I disorder
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12
Q

Axis 4

A
  • psychosocial and environmental problems
  • Primary support group-related to social environment
  • educational problems-occupational problems, housing problems
  • economic problems-problems w/access to health care services
  • problems related to interaction w/ legal system/crime
  • other psychosocial and environmental problems
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13
Q

Axis 5

A
  • Global Assessment of Functioning (GAF)
  • Scale 0-100 evaluating a persons ability to function in the world
  • 100-superior function in a wide range of activities life problems never get out of hand, sought out by others because of his or her positive qualities no symptoms
  • most of us-90’s absent or minimal symptoms, good functioning in all areas, interested and involved in a wide range of activities, socially effective, generally satisfied w/life, no more than everyday problems or concerns
  • 10-persistant danger of severely hurting self or others or persistent inability to maintain minimal personal hygiene or serious suicidal act w/ clear expectation of death
  • 30-behavior is considerably influenced by delusions or hallucinations or serious impairment in communication or judgment or inability to fxn in almost all areas
  • most people will meet criteria for something in DSM in our lifetimes
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14
Q

Lanterman-Petris-short Act (LPS)

A

Persons who qualify under the LPS statute are:
Persons who are a danger to self - suicidal or so grossly disorganized: Danger to others - homicidal: Gravely disabled due to mental illness - unable to provide for food, clothing, shelter
Patients get to an ED via law enforcement (squad car) around 30%, EMS/transport (ambulance) around 30%, and the remainder by family/friend/self.

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15
Q

WI 5150

A

DETAIN AND TRANSPORT

- detain and transport to a place of safety (i.e., an ED/acute hospital so designated by county government)

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16
Q

WI 5151

A

72 HR ASSESSMENT
- requires an assessment prior to admissions into the facility by a qualified professional to determine if the hold is appropriate. If it is not (i.e., If in the judgment of the professional person in charge of the facility providing evaluation and treatment, or his or her designee, the person can be properly served without being detained), he or she shall be provided evaluation, crisis intervention, or other inpatient or outpatient services on a voluntary basis). Once admitted only a psychiatrist can release within 72 hours

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17
Q

WI 5152

A

EVALUATION AND TREATMENT (72 hour clock starts)

- If the client refused voluntary continuation then a psychiatrist can hold for treatment for 14 days

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18
Q

ego dystonic

A

trait is alien, it is other

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19
Q

ego syntonic

A

that is who they are, they love that trait

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20
Q

WI 5250

A

14 DAY, 3 DAY EXTENSION WHEN CONSERVATORSHIP APPLIED FOR

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21
Q

Models

A
  1. pharmacological model
  2. psychodynamic model
  3. cognitive behavioral model
  4. behavioral model
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22
Q

Case formulation approach

A
  • multiple factors that contribute to the way the individual understands themselves in the world
  • patterns of responding to different stimuli (bio, psycho, social)
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23
Q

Psychodynamic model

A
  • FREUD

- focus on early development and how it influences personality development

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24
Q

Fundamental belief in psychodynamic theory

A
  • the way you respond to individuals around you is a result of the interactions you had as a baby and small child
  • leads you to understand other people and relationships with them in an unconscious way
25
Q

Freud’s stages of psychosexual development

A 
Oral - birth to 18mos
Anal - 18 mos to 3yrs
Phallic - 3 to 6 yrs
Latency - 6yrs to puberty
Genital - puberty on
26
Q

Oral stage

A
  • birth to 18mos
  • focused on oral pleasures (sucking)
  • too much or too little = oral fixation or oral personality; personality preoccupied with oral activities
  • tendency to smoke, drink, over eat, bite nails
  • (+) may be overly dependent on others, gullible, followers
  • (-) may be pessimistic, aggressive
27
Q

Anal stage

A
  • 18mos to 3 yrs
  • pleasure = eliminating and retaining feces
  • (+) anal fixation can result in obsession with cleanliness, perfection, and control (anal retentive)
  • (-) May become messy and disorganized (anal expulsive)
28
Q

Phallic stage

A
  • 3-6yrs
  • boys develop unconsicous sexual desires for their mother; becomes rivals with father (competition for mom’s affection) - known as OEDIPUS COMPLEX
  • out of fear of castration from dad, boys decide to identify with him rather than fight him; by doing so, boys develop masculine characteristics and identify as male - suppress sexual feelings toward mom
  • girls develop unconscious sexual attraction to dad - ELECTRA COMPLEX
  • fixation at this stage - sexual deviancies and weak or confused sexual identity
29
Q

Latency stage

A
  • 6yo to puberty
  • sexual urges remain repressed
  • children interact mostly with same sex peers
30
Q

genital stage

A
  • puberty on
  • final stage
  • sexual urges awakened again
  • direct sexual urges onto opposite sex peers
  • primary focus is on pleasure of genitals
31
Q

psychoanalysis

A
  • intended to help individuals go back and relook at some unconscious patterns of behavior that were formed in early important relationships
  • focus of psychoanalytic treatment
32
Q

psychoanalytic treatment

A
  • currently occurs rarely
  • pt lies on couch and stares into space
  • alysand (person being treated) has fantasies about analyst (person listening)
  • pt projects relationship ideas from important relationships onto the analyst
33
Q

transferance

A
  • leads pt to think analyst is very important and loves pt.

- engagement with analyst helps pt face difficult things

34
Q

classical analysis

A
  • reenactment of early important relationships to relationship in which they do not apply
  • expect transference because analyst is important and pt reacts to you in a way they would in the early attachment phase
35
Q

counter transference

A
  • you do what pt does back to pt
  • you reenact with pt important relationships you have had in your life
  • can be positive or negative
36
Q

Freud’s psychodynamic model

A

1st theory = structural model

  • Id (child) drives primal urges like sex, food, dominance, gratification
  • ego (adult) drives rational thinking (reality principle)
  • superego (parent) drives self regulation, should and should not, moral principle

2nd theory = hydrolytic theory
-defense mechanisms - not to keep other people away, but to keep unconscious material repressed (denial = primitive defense mechanism used by child) (humor = mature defense mechanism used by adult

37
Q

signal anxiety

A
  • leads to implementation of defense mechanisms

- intended to keep knowledge repressed because intolerable to conscious mind

38
Q

sublimination

A
  • I want to have a wife and kids, but i dont have any
  • use love to take care of another group
  • person is aware they are doing this
  • helps person to not focus on loss
39
Q

Psychosocial stages of development

A

Developed by Erickson (neofreudian)

  1. trust vs mistrust
  2. autonomy vs shame and doubt
  3. initiative vs guilt
  4. industry (competence) vs inferiority
  5. identity vs role confusion
  6. intimacy vs isolation
  7. generativity vs stagnation
  8. ego integrity vs despair
40
Q

trust vs mistrust

A
  • psychosocial stage of development
  • birth to 1 year
  • child will develop a sense of basic trust in world and his or her own ability
  • development depends on consistency of the child’s major caregiver
  • success at this stage = virtue of hope
  • failure at this stage = mistrust, anxiety, heightened insecurities
41
Q

autonomy vs shame and doubt

A

psychosocial stage of development

  • 2-3 yrs
  • child begins to assert independence
  • child needs support from parents so that repeated failures and ridicule are not the only experiences
  • parents need to encourage independence while still protecting child so that constant failure is avoided
  • success at this stage = virtue of will
  • failure at this stage = overly dependent upon others, lack self-esteem, feel sense of shame or doubt their abilities
42
Q

initiative vs guilt

A

psychosocial stage of development

  • 3-5 yrs
  • child will often overstep the mark in his forcefulness and the danger is that the parents will tend to punish the child and restrict his initiatives too much
  • healthy balance between initiative and guilt is important
  • success at this stage = virtue of purpose
  • failure at this stage = remain a follower, lacking in self initiative,, sense of guilt, inhibited creativity
43
Q

industry (competence) vs inferiority

A

psychosocial stage of development

  • 6-12 yrs
  • teachers begin to take an important role in childs life
  • child feels the need to win approval by demonstrating specific competencies that are valued by society
  • develop a sense of pride in their accomplishments
  • success in this stage = virtue of competence
  • failure in this stage = may be needed for child to develop modesty
44
Q

identity vs role confusion

A

psychosocial stage of development

  • 13-18 yrs
  • child learns the roles he will occupy as an adult
  • at the end of this stage, the person will have a reintegrated sense of self, and of their appropriate sex role
  • success in this stage = virtue of fidelity
45
Q

intimacy vs isolation

A

psychosocial stage of development

  • young adulthood
  • success in this stage = comfortable relationships and a sense of commitment, safety, and care within a relationship
  • failure in this stage = avoiding intimacy, fearing commitment and relationships can lead to isolation, loneliness, and sometimes depression
46
Q

generativity vs stagnation

A

psychosocial stage of development

  • middle adulthood
  • establish careers, settle down in relationship, begin families, develop sense of being part of the bigger picture
  • give back to society through raising children and work productivity
  • failure at this stage = stagnant and feel unproductive
47
Q

ego integrity vs despair

A

psychosocial stage of development

  • old age
  • slow down in productivity
  • contemplate accomplishments and develop integrity
  • if life as seen as unproductive, feel guilt about past and feel dissatisfied with life and develop despair. Leads to depression and hopelessness
48
Q

human potential movement

A
  • humanistic model
  • emphasizes value and intrinsic self-worth of every individual focuses on quality of the relationship and capacity of the pt to heal themselves
  • people will develop appropriately if provided the right type of nurturing environment
  • contradicts pessimistic Freudian position
  • humans are innately good and driven to achieve self actualization
49
Q

karl rogers

A

“client centered therapy”

  • unconditional positive regard
  • warmth
  • accurate empathy
  • genuineness
  • reflective listening
50
Q

Behavioral model

A
  • focus on behavior only, not what causes it
  • relationship most important thing in getting people to comply
  • single biggest predictor of behavior outcome is relationship
  • classical conditioning and operant conditioning
51
Q

opperant conditioning

A
  • used to help people move out into community from hospital
  • ex) girl thought she was going to kill herself while on a bridge, left the bridge and had decreased anxiety/feelings, she realized she couldn’t go on the bridge anymore
  • before meds were available, wrap people in cold blanket
  • A = antecedent - happns before behavior, increases or decreases the chances that behavior occurs (i.e. red light = stop)
  • B = behavior
  • C = consequences
  • positive and negative reinforcement
52
Q

classical conditioning

A

-pavlov’s dogs

53
Q

systematic desensitization

A
  • intervention method
  • pt has fear of bunny –> show them cartoon bunny –> show them photo of bunny –> bring in stuffed bunny –> bring in small bunny
54
Q

reinforcement

A
  • anything that increases the chances that behavior will be emitted
  • positive reinforcement - addition of something increases behavior to be displayed
  • negative reinforcement - removing something increases behavior to be displayed (ex. when you’re good, you dont have to do dishes after dinner)
55
Q

punishment

A
  • opposite of reinforcement
  • not done very often because it can be damaging to clinicians
  • positive punishment - introduction of something intended to decrease the behavior from being displayed
  • negative punishment - removing something that person wants (ex. hit dave, no movies)
56
Q

Cognitive behavior model

A
  • behavior, cognition, and emotions are interdependent
  • introspection provides no privileged access to cause
  • consciousness does not provide “privileged access” to cause of behavior

1st thing to look at: Automatic thoughts - same thought over and over again (can cause depression)
-automatic thoughts can be sub-vocal mental dialogue or running commentary

2nd thing to look at: Perceptual distortions - individuals misperceive whats going on to fit their negative interpretation
-all or none thinking - if a person doesnt love me, im worthless

-most valuable part of cognitive behavior therapy is the person noticing what they are thinking

57
Q

schemas

A

-built from automatic thoughts - ways of thinking about cognitive triad - self, world, future

58
Q

cognitive behavioral conceptualization of depression

A
  • negative automatic thoughts
  • reduced pleasant behaviors/social withdrawal
  • activating perceptual distortion and negative self schemas
59
Q

downward arrow technique

A
  • way to undermine the thinking error pt gets into to change their schemas
  • ex) what happens if mildred leaves? I will never be happy and i will have to kill myself. Have you ever been in another relationship? Yes
  • pt realizes that there was once a time in his life that he was happy without Mildred

Behavioral Medicine (4 decks)

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