Assessment of Dangerousness Flashcards Preview

PSYCH > Assessment of Dangerousness > Flashcards

Flashcards in Assessment of Dangerousness Deck (24):
0

how often are suicides successful?

once out of every 8-10 attempts

1

Risk factors for suicide

major depression (accounts for 50%)
alcoholism and drug dependence (50%)
schizophrenia
personality disorders
medical risk factors
family and genetic factors
social risk factors

2

age most likely to commit suicide

15-24 years
>60 years

3

gender

women 3x more likely to attempt
men 3x more likely to complete

4

biological markers

decreased CSF level of 5HT and 5-HIAA
HPA axis hyperactivity

5

treatment for decrease risk of suicide

lithium
clozapine
ECT

6

not proven to decrease overall suicide risk

SSRIs

7

even a week's supply of some antidepressants

can be lethal

8

4 things to monitor

intentionality- what is the level of expressed intention?
lethality- does the patient have a plans? How lethal is the plan?
Means- does the patient have th emeans to carry out their plan?
Viability- What is the ability of the patient to accept help and hope?

9

Tarasoff Warning

duty to warn intended victim
duty to protect intended victim

10

aggression

overt behavior involving intent to inflict noxious stimulation or to behave destructively towards another organism

may be impulsive or premediated

11

agitation

state of poorly organized and aimless psychmotor activity- stems from a state of physical and mental unease

emergency

12

red flags for likely medical cause

new onset agitation ina dult over age 45 with no psych histroy
not consistent with known psych history
abnormal vital signs
abnormal PE findings
signs/sx of drug/alch intox
signs/sx of drug/alch withdrawal
confusion, disorientation, deficits in attn and cognition

13

cycles of de-escalation

listen to patient
find a way to agree with/validate patient
state what you want the patient to do

14

a drug is considered a restraint when

used to restrict behavior or movement and is not a standrad treatment or dosage for condition

15

three types of drugs studied for agitation managament

1st generation antipsychotics- haldo
2nd generation antispychotics- dopamine-5ht antagonists (risperidone,etc)-dopamine antagonism
benzos

16

benzos are not preferred when

agitation is secondary to psychosis- will just sedate and not address underlying cause, but if agitation is unknown and no psychosis- benzos are considerd a first line agent

17

for acute agitation

antihistamine
benzos
nonbenzo anxiolytuics
neuroleptics

18

anxiety treatmetn

GABA agonist dampensens CNS response; bblockers symp resonse to stress

19

fear disorganization frankpsychosis delirum

DA blockade

20

tendency towards violence

substance abusing patient
psychaitric agitated patient
delirious patient

21

treatment substnace abusing

destimlate
monitor and support
dopamine antagonism

22

EtOH withdrawal

thiamaine, folate, MVI
benzos
dopamine antagonism

23

delerious patient treatment

treat underlying organic etiology
minimize anticholinergic agents and benzos
dopamine antag