Chapter 2 Mental Health and Mental Illness Flashcards Preview

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Flashcards in Chapter 2 Mental Health and Mental Illness Deck (85)
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31

The 1999 USDHHS report entitled Mental Health: A Report of the Surgeon General stated the following:

•Mental health is fundamental to health.
•Mental disorders are real health conditions that have an immense impact on individuals and families.
•The efficacy of mental health treatment is well documented.
•A range of treatments exists for most mental disorders.

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One method many states use to determine coverage is by making a distinction of whether the problem is a biologically based mental illness, that is, a mental disorder caused by?

neurotransmitter dysfunction, abnormal brain structure, inherited genetic factors, or other biological causes. Another term for such an illness is psychobiological disorder.

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psychobiological disorder. These biologically influenced illnesses include the following:

•Schizophrenia
•Bipolar disorder
•Major depression
•Obsessive-compulsive and panic disorders
•Posttraumatic stress disorder
•Autism

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Other severe and disabling mental disorders include the following:

•Anorexia nervosa
•Attention deficit/hyperactivity disorder
•Many of the most prevalent and disabling mental disorders have been found to have strong biological influences; therefore we can look at these disorders as “diseases.”

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The DSM cautions that the emphasis on the term mental disorder implies a distinction between “mental” disorder and “physical” disorder, which is an outdated concept, and stresses mind-body dualism:

“There is much ‘physical’ in ‘mental’ disorders and much ‘mental’ in ‘physical’ disorders”

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In the DSM each of the mental disorders is conceptualized as a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and is associated with?

present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.

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It is important to stress that the DSM classifies disorders that people have, and not the person. For this reason, the text of the DSM avoids the use of expressions such as “a schizophrenic” or “an alcoholic” and instead uses the more accurate terms?

“an individual with schizophrenia” or “an individual with alcohol dependence.”

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Spirituality is a much broader concept than just religion alone; spirituality

“provides an essential core, enriching experience, and a reason to live for many people”

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Favazza (2009) cites the following examples of how people obtain an altered state of consciousness, which is spiritually enriching and brings peace and serenity into people's lives.

Mysticism, meditation (e.g., Dhyana, a form of concentrated meditation taught by Buddha; Zen Buddhism, a Japanese practice in which a spiritual master instructs students in meditation, used throughout the United States; and transcendental meditation, a Hindu meditative process), and mindfulness meditation (derived from Buddhist practice) are just a few examples.

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Mindfulness meditation is used today and has many health benefits; it is a valuable tool for dealing with chronic pain and stress. It is actively employed with?

dialectic behavioral therapy (DBT), stress reduction programs, and some forms of cognitive therapy

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most widely used in the United States; it is used for many reasons and is also tied to many different cultures.

Prayer

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The DSM axis system forces the diagnostician to consider a broad range of information by requiring judgments to be made on each of five axes.

- Axis I: collection of signs and symptoms that constitute particular disorder (for example, schizophrenia) or a condition that may be a focus of treatment
- Axis II: personality disorders and mental retardation.
* Axes I and II constitute classification of abnormal behavior
- Axis III the clinician indicates any general medical conditions believed to be relevant to the mental disorder in question
- Axis IV is for reporting psychosocial and environmental problems that may affect the diagnosis, treatment, and prognosis of a mental disorder. These may include occupational problems, educational problems, economic problems, interpersonal difficulties with family members, and a variety of problems in other life areas
- Axis V, called Global Assessment of Functioning (GAF), gives an indication of the person's best level of psychological, social, and occupational functioning during the preceding year, rated on a scale of 1 to 100 (1 indicates persistent danger of severely hurting oneself or others, and 100 indicates superior functioning in a variety of activities at the time of the evaluation, as well as the highest level of functioning for at least a few months during the past year)

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Stigma is a?

“collection of negative attitudes, beliefs, thoughts, and behaviors that influence the individual, or the general public, fear, reject, or avoid, be prejudiced, and discriminate people”

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Goffman's classic definition of stigma is

“an attribute that is deeply discrediting where a person is reduced from a whole unusual person to a tainted, discounted one”

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psychosocial processes that lead to stigmatization

Stereotyping, labeling, separating, status, loss, and discrimination in a context of power imbalance are many of the psychosocial processes that lead to stigmatization.

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GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗
100>91

Superior functioning in a wide range of activities, life's problems never seem to get out of hand, is sought out by others because of his or her many positive qualities. No symptoms.

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GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗
90>81

Absent or minimal symptoms (e.g., mild anxiety before an exam), good functioning in all areas, interested and involved in a wide range of activities, socially effective, generally satisfied with life, no more than everyday problems or concerns (e.g., an occasional argument with family members).

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GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗
80>71

If symptoms are present, they are transient and expected reactions to psychosocial stressors (e.g., difficulty concentrating after family argument); no more than slight impairment in social, occupational, or school functioning (e.g., temporarily falling behind in schoolwork).

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GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗
70>61

Some mild symptoms (e.g., depressed mood and mild insomnia) OR some difficulty in social, occupational, or school functioning (e.g., occasional truancy, or theft within the household), but generally functioning pretty well, has some meaningful interpersonal relationships.

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GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗
60>51

Moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) OR moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or coworkers).

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GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗
50>41

Serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) OR any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job).

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GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗
40>31

Some impairment in reality testing or communication (e.g., speech is at times illogical, obscure, or irrelevant) OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood (e.g., depressed man avoids friends, neglects family, and is unable to work; child frequently beats up younger children, is defiant at home, and is failing at school).

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GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗
30>21

Behavior is considerably influenced by delusions or hallucinations OR serious impairment in communication or judgment (e.g., sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) OR inability to function in almost all areas (e.g., stays in bed all day; no job, home, or friends).

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GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗
20>11

Some danger of hurting self or others (e.g., suicide attempts without clear expectation of death; frequently violent; manic excitement) OR occasionally fails to maintain minimal personal hygiene (e.g., smears feces) OR gross impairment in communication (e.g., largely incoherent or mute).

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GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗
10>1

Persistent danger of severely hurting self or others (e.g., recurrent violence) OR persistent inability to maintain minimal personal hygiene OR serious suicidal act with clear expectation of death.

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GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗
0

Inadequate information.

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Psychiatric mental health nursing includes the diagnosis and treatment of human responses to?

actual or potential mental health problems.

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NANDA International (NANDA-I) describes a nursing diagnosis as a?

clinical judgment about individual, family, or community responses to actual or potential health problems and life processes.

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the DSM is used to diagnose a psychiatric disorder, whereas a well-defined nursing diagnosis provides the framework for identifying?

appropriate nursing interventions for dealing with the phenomena a patient with a mental health disorder is experiencing (e.g., hallucinations, self-esteem issues, impaired ability to function).

60

The DSM includes information specifically related to culture in three areas:

1. A discussion of cultural variations for each of the clinical disorders
2. A description of culture-bound syndromes
3. An outline designed to assist the clinician in evaluating and reporting the impact of the individual's cultural context