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Behavioral Dynamics > Behavioral Dynamics Exam 1 Cards > Flashcards

Behavioral Dynamics Exam 1 Cards Flashcards

1
Q

4 D’s of psychiatric disease

A

Deviance, Dysfunction, Distress, Danger

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2
Q

What is a Deviant Behavior?

A

A behavior that is extreme or unusual from social norms

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3
Q

What is a distressing behavior?

A

A behavior that is considered unpleasant and unsettling to the patient

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4
Q

What is a dysfunctional behavior

A

A behavior that interferes with the patient’s daily functioning

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5
Q

What is a dangerous behavior

A

A behavior that poses the risk of harm to self or others

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6
Q

Scope of practice of a Psychology PhD.

A

Psychologist who participates in clinical counseling and research

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7
Q

Scope of practice of a Psychology PhD.

A

Psychologist who participates in clinical counseling and research

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8
Q

Scope of practice of a Psy.D.

A

Psychologist who is closer to a physician but has limited or no prescribing ability

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9
Q

Scope of practice for a Psychiatrist

A

MD or DO who can write medication, usually in a clinical setting

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10
Q

Scope of practice for a Psychiatrist

A

MD or DO who can write medication, usually in a clinical setting

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11
Q

Scope of practice of a Psychiatric nurse?

A

Works with hospitalized psychiatric patients to improve functioning and manages various aspects of treatment

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12
Q

Scope of practice of Psych PA or NP

A

Works with supervising Psychiatrist assesing clients and prescribing meds

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13
Q

How prevalent is mental illness in the US

A

50% of adults will experience mental illness during their life, 1 in 5 experience mental illness in a given year

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13
Q

How prevalent is mental illness in the US

A

50% of adults will experience mental illness during their life, 1 in 5 experience mental illness in a given year

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14
Q

4 Adverse effects of poor mental health on physical health

A

Decreased use of medical care, Reduced adherence, Higher risks of adverse outcomes, Increased tobacco and alcohol use

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15
Q

2 Concerns with the DSM-V

A

Too subjective with not enough scientific bases, Diagnoses too closely based on social norms or cultural biases

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16
Q

4 Concerns with the DSM-V

A

Too subjective with not enough scientific bases, Diagnoses too closely based on social norms or cultural biases, supports chemical imbalance theories without strong evidence, mediation first approach to treatment encouraged

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17
Q

3 Elements that make a psychiatric note different from other notes

A

More subjectivity, Less validating criteria, Lower diagnostic reliability

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18
Q

4 Parts of a Psych note

A

General information (Name, Age, Sex, Race, Income, Address)

Chief Complaint

Historical Information (HPI, Psych, Medical, Substance Use, Family, Developmental, Educational, Vocational or Military, Sexual, Legal, Residential)

Objective exam (General, MSK/Neuro, Skin, Psych)

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19
Q

How is a Psychiatric evaluation different from a physical evaluation

A

It dives deeper into a patient’s history in an attempt to understand how their past has affected their present condition

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19
Q

How is a Psychiatric evaluation different from a physical evaluation

A

It dives deeper into a patient’s history in an attempt to understand how their past has affected their present condition

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20
Q

Psychodynamics

A

Collective aggregate of conscious and unconscious factors that influence personality, behavior and attitudes

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21
Q

Psychoanalysis

A

Method of treating mental and emotional disorders based around revealing and investigating the role of unconscious and conscious desires

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22
Q

Psychotherapy

A

Use of verbal methods to influence another person’s mental and emotional state

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23
Q

Psychodynamic theory views behavior as the product of a(n) _____________________ ___________________

A

Internal Discussion

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24
Q

Id

A

Greedy inner child that acts on primal instincts and desires. Seeks gratification and pleasure no matter the cost

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25
Q

Superego

A

Image of what one should strive to be, morals and internal conscience that is at odds with the id

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26
Q

Ego

A

Grown up self which has to balance the id and the superego. May make decisions that either cause or reduce anxiety

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27
Q

How the id, ego, and superego interplay with conscious and unconscious thinking

A

The Id is mostly subconscious while the super ego is both and the ego is mostly conscious

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28
Q

Mature ego defense mechanisms

A

Defense mechanisms that do not compromise other functioning

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29
Q

Primitive ego defense mechanisms

A

Defense mechanisms that do compromise mature functioning

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30
Q

3 factors that determine defense mechanism use

A

Psychological maturity, Developmental history, Intensity of distress or anxiety

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31
Q

Regression

A

Retreating to an earlier stage of development

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32
Q

Denial

A

Behaving as if things are different than they really are, if severe can be described as a delusion

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33
Q

Projection

A

Attributing one’s own unacceptable feelings to another person, can be used as an excuse for one’s own feelings

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34
Q

Intellectualization

A

Focusing on minor, often unimportant details of a situation rather than addressing the main central conflic

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35
Q

Repression

A

Placing disagreeable or unacceptable thoughts in the subconscious mind rather than dealing with them

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36
Q

Displacement

A

Expressing feelings or impulses toward one group or person onto another group or person that is less threatening (ie. getting made at spouse instead of boss)

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37
Q

Rationalization

A

Reinterpreting the facts/lying to ourselves

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38
Q

Dissociation

A

Disconnecting from a stressful situation by pursuing an alternate reality, lying to ourselves

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39
Q

Reaction Formation

A

A person goes into denial by acting opposite to the way that they truly feel

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40
Q

Suppression

A

Thoughts are put into the subconscious and are dealt with at a future date

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41
Q

Sublimation

A

Channeling unacceptable impulses into socially appropriate activities, allowing one to use their energy in better ways

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42
Q

Six expanded roles of the ego in Ego psychology

A

Reality testing, impulse control, Affect regulation, judgement, Synthetic functioning, defense mechanisms

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43
Q

Erik Erikson theory of development

A

8 stages of development from child to adult

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44
Q

Object relations psychology

A

Humans are shaped in relation to the significant other surrounding them; primary motivators are relationships rather than sexual or aggressive impulses

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45
Q

Self Psychology

A

The “self” is derived from their perception of their identity, personal awareness and personal experiences including self esteem

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46
Q

Strengths of Psychodynamic theory (3)

A

Focuses on how the past influences the present, Acknowledges the subconscious, Does seem to help patients

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47
Q

Weaknesses of Psychodynamic theory (4)

A

Ignores biological components, Depends on therapist interpretation, Can focus too much on the past and under emphasize the present, Not scientifically proven

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48
Q

Humanistic persepctive

A

Humans are basically good, well nurtured children with develop into emotionally healthy adults. Problems are the result of caregiver failure

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49
Q

Client centered therapy

A

Unconditional positive regard that encourages patient to generate ideas rather than decoding their mind

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50
Q

Behaviorist perspective

A

Belief that behavior is determined by the environment. People are born as a blank slate and develop as the result of external stimuli

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51
Q

Goal of behaviorist therapy

A

To alter offensive stimuli or recondition oneself to constructive behaviors

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52
Q

Goal of humanistic therapy

A

Self-Actualization

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53
Q

Cognitive-Behavioral Perspective

A

Automatic thoughts lead to irrational assumptions which shape behavior

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54
Q

Arbitrary Inference

A

Drawing unwarranted conclusions on the basis of little or no evidence

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55
Q

Selective abstraction

A

Drawing conclusions on the basis of a single piece of data while ignoring contradictory data

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56
Q

Personalization

A

Taking the blame for something that is clearly not one’s fault

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57
Q

Overgeneralization

A

Drawing a general conclusion on the basis of a single, sometimes insignificant event

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58
Q

Goal of CBT

A

To discover faulty thinking processes through a therapeutic relationship with the patient and allow them to become aware of the maladaptive cognition and change it

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59
Q

Maslow’s Needs

A

Physiological, Safety and Security, Love and Belonging, Self Esteem, Self Actualization

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60
Q

Classical conditioning

A

Conditioning as seen with Pavlov’s dogs

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61
Q

Unconditioned stimulus

A

Stimulus that produces a response without any need for conditioning

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62
Q

Unconditioned response

A

Response to unconditioned stimulus

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63
Q

Conditioned stimulus

A

Neutral stimulus that later comes to elicit a response

64
Q

Conditioned response

A

Response to a conditioned stimulus

65
Q

What determines the speed of classical conditioning?

A

The strength of the unconditioned response: people learn fears quickly and unlearn them slowly

66
Q

Generalization of Stimuli

A

Similar stimuli to the conditioned stimulus also produce the conditioned response

67
Q

Extinction of CR

A

The process of unlearning a conditioned response

68
Q

Operant conditioning

A

Learning occurs as the result of positive or negative repercussions to our actions

69
Q

4 Types of reinforcement

A

Positive reinforcement: Reward for good behavior
Negative reinforcement: Removal of noxious stimulus for good behavior
Punishment: Application of averse stimulus
Response cost: removal of positive stimulus for unwanted behavior

70
Q

What determines time to extinction of operant conditioning

A

Whether it is continuous or Intermittent
Continuous reinforcement leads to more rapid extinction

71
Q

Secondary reward conditioning

A

Instrumental behavior to get a stimulus is useless but associated with a significant stimulus

72
Q

Avoidance conditioning

A

Response cue is instrumental in avoiding a painful or negative experience

73
Q

Habituation

A

Decrease in response to a stimulus after constant exposure, strong stimuli result in slower habituation, some stimuli are not subject to habituation

74
Q

Skoliosexual

A

Someone who is specifically attracted to non-gender conforming persons

75
Q

Sexual Behavior

A

Specific actions and behaviors involving sexual activities, may or may not align with someone’s sexual identity or orientation

76
Q

Gender expression

A

How one presents one’s gender to others

77
Q

Gender discordance/dysphoria

A

Discrepancy between assigned biological gender and gender identity

78
Q

Transgender or Transsexual

A

Gender discordant people who make changes to their perceived gender or anatomic sex in order to conform with their gender identity

79
Q

Normal stages of sexual stimulation (4)

A

Desire, Excitement, Orgasm, Resolution

80
Q

Sexual Arousal

A

Second sexual stage brought on by psychological OR physiological stimulation

81
Q

Orgasm

A

Peaking of sexual pleasure and releasing of sexual tension involves rhythmic contraction of perineal muscles and pelvic reproductive organs increase in BP, pulse, and respiratory rate

82
Q

3 Hormones that increase sexual desire

A

Dopamine, Testosterone, Estrogen (in women only)

83
Q

2 hormones that decrease sexual desire

A

Serotonin and Progesterone

84
Q

Normal stimuli for sexual desire in males and females

A

Predominantly physical for males predominantly psychologic for females

85
Q

Hypoactive sexual desire disorder

A

Deficiency or absence of sexual fantasies or desire for sexual activity. Prevalence estimated at 20%, more common in females

86
Q

Sexual aversion disorder

A

Characterized by an aversion to and avoidance of genital sexual contact

87
Q

Treatments for Sexual desire disorders Pharm and non-Pharm

A

Therapy - CBT, Sex, or couples therapy
Drugs:
Serotonergic (different from SSRIs) - Flibanserin (Addyi)
Melanocortin agonists - bremelanotide (Vyleesi)
Testosterone and Estrogen

88
Q

Female Sexual Arousal Disorder

A

Difficulty of the lubrication and swelling response of sexual excitement can occur in otherwise happy couples and may result from psychological factors

89
Q

Treatment for female sexual arousal disroder (4)

A

Therapy for psych factors, Testosterone (10% standard dose for men, Bupropion if SSRI related, Sildenafil (Viagra)

90
Q

Male Erectile Disorder

A

Same as erectile dysfunction, 10-20% of all men and increases with age although not universally

91
Q

3 factors that play a role in halting Male ED

A

Available sex partner
History of consistent sexual activity
Absence of vascular disease

92
Q

Assessing cause of ED

A

Usually more psychological with younger patients, important to not whether problems are universal or circumstantial (ie does it happen at night, etc.)

93
Q

Female orgasmic disorder

A

A recurrent delay in or absence of orgasm after a normal sexual excitement phase, 30-35% of women

94
Q

Physiologic factors that contribute to female orgasm disorder

A

Pelvic complaints such as Endometriosis, childbirth and atrophy of genital tissue
Insufficient Clitoral stimulation

95
Q

Male orgasmic disorder

A

Ejaculation only achieved after great difficulty if at all, 5% prevalence. Psychological if lifelong

96
Q

Treatment for male orgasmic disorder

A

Therapy and potentially dopamine agonsits

97
Q

Premature ejaculation

A

Generally when a man ejaculates before or immediately after entering his partner. Second most common CC in men w/ sexual disorders

98
Q

Treatment for Premature Ejaculation

A

May have a psych cause, May resolve on its own with the inexperienced, Squeeze technique, SSRI can be considered

99
Q

Dyspareunia

A

Genital pain occuring in either men or women before, during or after intercourse

100
Q

Vaginismus

A

Vaginal spasm of the distal 1/3 of the vagina that can have a physiologic cause or be the result of sexual abuse or trauma. Most common in the highly educated

101
Q

Physiologic diagnostics for male ED (3)

A

Lab studies (glucose, A1c, hormone, liver, lipid, thyroid)
Nocturnal penile tumescence
Assessing blood flow to the pudendal artery

102
Q

Affect of antipsychotics and antidepressants on sexually relevant hormones

A

Antipsych - reduces dopamine
Antidepressants - Increase serotonin

103
Q

Anticholinergic effect of sexual activity

A

May result in dry mucous membranes

104
Q

Hormonal medications that can interfere with sexual activity and how (2)

A

Contraceptives (increase estrogen, progesterone, LH)
Anti androgen therapy - Lowers testosterone (ie. spironolactone)

105
Q

4 Diagnostic criteria for a Sexual Dysfunction disorder

A

Experience disorder 75-100% of the time
Experience for at least 6 months
Have significant distress due to disorder
Lack of alternate explanations

106
Q

Persistent Genital Arousal Disorder Presentation and Treatment

A

Sexual arousal NOT associated with psychological desire - spontaneous, persistent, and difficult to control

Physical arousal that lasts from hours to weeks at a time

SSRI’s, psychotherapy, topical or injected anesthetic agents

107
Q

4 different therapy options for treating sexual disorders

A

Dual sex therapy, Behavior therapy, Group therapy, Analytically oriented sex therapy

108
Q

Exhibitionism

A

Achievement of arousal by exposing genitalia to strangers

109
Q

Transvestitism

A

Cross-dressing in a heterosexual man - often part of masturbation foreplay

110
Q

Voyerism

A

Attaining arousal watching an unsuspecting person or people esp. while engaged in sexual activities

111
Q

Pedophilia

A

Use of a child to achieve sexual arousal and gratification

112
Q

Incest

A

Sexual relationship with a member of ones immediate family - often a child

113
Q

Sexual sadism

A

Inflicting pain upon the sexual object as a means of arousal

114
Q

Sexual masochism

A

Erotic pleasure achieved by being humiliated, enslaved, bound or physically restrained

115
Q

Fetishism

A

Erotic fantasies, sexual urges or behavior involving non-living objects

116
Q

Frotteurism

A

Sexual arousal derived from touching or rubbing against a non-consenting person. Commonly done in crowded public areas

117
Q

4 potential treatments for paraphilias

A

Behavioral therapy, SSRIs, Gonadotropin antagonists, Progesterone therapy

118
Q

How should risk be related to patients in a numerical sense?

A

Numbers rather than percentages

119
Q

Bio-Psycho-Social Model

A

The idea that biological, social, and psychological factors all play a role in a persons condition

120
Q

5 core concepts of a patient-provider relationship

A

Attentiveness, Support, Partnership, Respect, Empathy

121
Q

Haptics

A

Communication through touch

122
Q

Kinesics

A

Nonverbal communication that involves body movement

123
Q

Proxemics

A

Non-verbal communication through spatial relation to others (being close or far away)

124
Q

Paralanguage

A

Nonverbal speech patterns such as pitch, tone, volume, speed, and rhythm

125
Q

Autonomic Nonverbal Communication

A

ANS responses such as sweating that might be picked up by the patient

126
Q

Safe pattern

A

patient’s body is relaxed and in an open position

127
Q

Fight pattern

A

Patient’s body is engaged but has increasing tension response due to feeling unsafe

128
Q

Flight pattern

A

Patient’s body is not engages and has increased tension - guarding or pulling away

129
Q

Withdrawal pattern

A

Patient is not engaged, withdrawn and unable to mount a response

130
Q

4 common clinical patterns

A

Safe, Fight, Flight, Withdrawal

131
Q

Word you should avoid when talking about patient constraints

A

ONLY

132
Q

Two approaches to agenda setting with a patient

A

Ask open ended questions to figure out patient priorities and create flow

Indicate time available and figure out what can be addressed and what needs to be put off

133
Q

Clinician vs. Patient Centered HPI

A

Clinician centered - More direct/closed ended questions
Patient centered - More open ended questions - letting the patient talk

134
Q

Method of patient education - Ask Ask Tell Ask

A

Ask for permission to explain information
Ask what the patient already knows
Customize message to level of patient understanding
Ask the patient to repeat back key elements

135
Q

Medical Family Concept vs. Social Family Concept

A

Medical - Biological relationships
Social - People they live with/support system

136
Q

Hierarchical control

A

Team with a pyramid like structure where there is one leader and others are in lower tiers of authority

137
Q

Relationship centered teamwork

A

Team in which the center of authority may shift based upon the situation

138
Q

Plenary discussion

A

Facilitator leads a discussion with opportunities for group comment

139
Q

Report/Presentation Meeting

A

One person gives a report with an opportunity for Q&A at the end

140
Q

Brainstorm meeting

A

Members volunteer ideas

141
Q

Go-round meeting

A

Go around the table and let everyone speak

142
Q

Heterogenous fishbowl

A

People representing different points of veiw participate

143
Q

Homogenous fishbowl

A

One point of view discusses at a time

144
Q

5 A intervention model

A

Ask
Advise
Assess
Assist
Arrange

145
Q

Precontemplation stage

A

Stage where a person is not even considering change. May not believe change is possible because of failure or may not believe behavior is harmful

146
Q

Contemplation stage

A

Ambivalent about change - giving up behavior makes them feel a sense of loss - I know I need to but

147
Q

Preparation stage

A

Experiment with small changes as determination increases to change - Preparation stage

148
Q

Action stage

A

Actively pursuing change - often patient needs support

149
Q

Maintenance stage

A

Change becomes incorporated, patient may still need support with relapses

150
Q

5 stages of change

A

Precontemplation
Contemplation
Preparation
Action
Maintenance

(Relapse)

151
Q

Adherence

A

Extent to which the patients behavior correlates with agreed upon recommendations from a healthcare provider

152
Q

Adherence by patients with chronic disease in developed countries

A

About 50%

153
Q

SPIKES protocol for giving bad news

A

Setup, Perception, Invitation, Knowledge, Empathize, Summarize and Strategize

154
Q

Death Technical definition

A

Irreversible cessation of vital functions OR irreversible cessation of all functions of the entire brain

155
Q

Bereavement

A

Reaction to the loss of a close relationship

156
Q

Mourning

A

Process by which a bereaved individual undoes bonds to the deceased and settles into their grief

157
Q

Attitude towards death at 5, 5-10, and 10+

A

5 - Separation similar to sleep
5-10 Inevitable human mortality, fear of parents dying
10+ Realize that death can happen to them and that it is universal and irreversible

158
Q

Minimum criteria for a prolonged grief disorder

A

At least one year has elapsed since the bereavement and grief is excessive in relation to cultural norms and give significant distress

159
Q

Suicide in grief versus depression

A

Grief - Life is unbearable but don’t want to die

Depression - More likely to threaten suicide

Behavioral Dynamics (3 decks)

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