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Flashcards in DSM Dx/Criteria Deck (248):
1

DSM IV Axes

I psychiatric dx
II personality d/o, MR, developmental delays
III medical conditions
IV psychosocial/environmental px affecting tx
V global clinician rating GAF

2

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.
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).
80 - 71
If symptoms are present, they are transient and expectable reactions to
psychosocial stressors
(e.g., difficulty concentrat
ing after family argument);
no more than slight impairment in social, occupational or school functioning
(e.g.,
temporarily failing behind in schoolwork).
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.
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 co-workers).
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).
40 - 31
Some impairment in realit
y 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).
30 - 21
Behavior is considerably influenced by delusions or hallucinations
OR serious impairment in communication or judgment
(e.g., sometimes
incoherent, acts grossly inappropriat
ely, suicidal preoccupation)
OR inability to function in almost all areas
(e.g., stays in bed all day; no job, home,
or friends).
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).
10 - 1
Persistent danger of severely hurting self or others
(e.g., recurrent violence)
OR persistent inability to main
tain minimal personal hygiene
OR serious suicidal act with clear expectation of death.
0
Inadequate information.

3

Time criteria for MDD

sx last at least 2 weeks

4

time criteria for dysthymic d/o

depressive mood for atleast 2 years

5

time criteria for bipolar 1 d/o

(mania) persistently elevated, expansive or irritable mood lasting at least 1 week
*does not have to have depressive episode

6

criteria for bipolar II d/o

*depressive episode at least 1
*hypomanic episode at least 1
hypomanic has to last for at least 4 days
*never have psychotic sx or manic or mixed episode

7

criteria for cyclothymic d/o

hypomanic and depressive sx that don't meet criteria for MDD or bipolar
*sx last at least 2 years and not with out sx for longer than 2 months

8

criteria for panic d/o

period of intense fear/discomfort
*4 sx phys/behav and reach peak within 10min
1 month or mor of at least having a concern about future attacks or worry of attacks or change in behavior r/t attacks

9

criteria for social phobia/social anxiety d/o

persistent fear of 1 or more social/performance situations
*if under 18 must last at least 6 months

10

criteria for OCD

marked distress, time consuming (more than 1 hour per day)
can have obsession=thoughts or compulsions=behaviors

11

criteria for PTSD

sx last greater than 1 month and exposed to traumatic event or threatened
acute-less than 3 months
chronic-great than 3 months

12

criteria for acute stress d/o (ASD)

sx last at least 2 days but not longer than 4 wks or 1 month

13

criteria for GAD

excessive worry/anxiety for at least 6 months

14

criteria for dementia

2 or more of: Aphasia (language), Apraxia (motor), Agnosia (recognizing objects), and executive functioning px

15

criteria for schizophrenia

hallucinations, delusions, disorganized thoughts and speech and behavior and negative sx (need 2 or more for at least 1 month unless bizarre delusions or hallucinations consisting of voice keeping running commentary or 2 or more voices conversing with each other)
*continuous s/s persistis at least 6 months

16

criteria for schizoaffective d/o

have schizophrenia along with depressive episode or manic or mixed episode
delusions or hallucinations in absence of mood issue have to last for at least 2 weeks and mood sx present for substantial portion of total duration of active and residual periods
*have mood in between + sx

17

criteria for schizophreniform d/o

criteria met for schizophrenia except that the s/s have been present for at least 1 month but less than 6 months

18

criteria for brief psychotic d/o

have 1 or more (delusion, hallucination, disorganized speech and behavior) lasting 1 day but less than 1 month with full return to premorbid funcitoning

19

criteria for delusional d/o

non bizarre delusions for at least 1 month
subtypes: erotomanic (believes another is in love with them); grandiose, jealous, persecutory, somatic, mixed, unspecified type

20

alcohol withdrawal

tremulousness 68 hours after cessation
psychotic and perceptual 8-12 hours
seizures 12-24 hours
DT's any first 72 hours
delerium can occu in 1 week after cessation

sx: autonomic hyperactivity, increased hand tremor, insomnia, n/v, transient hallucinations/illusions, psychomotor agitation, anxiety, grand mal seizures

21

CIWA scoring

0-9 absent or minimal w/drawal
10-19 mild to mod
> or equal to 20 severe w/ drawal
tx often BZDs

22

acute intoxication of opiods
criteria

apathy/sedation, disinhibition, psychomotor retardation, impaired attention and judgment;
atleast 1 of the following (drowsy, slurred speech, pupillary constriction, decreased LOC)

23

opioid w/drawal

n/v, runny nose or lacrimation, pupillary dilation, piloerection, diaphroesis, diarrhea, yawning, fever, insomnia

24

cluster A personality d/o

paranoid, schizotypal, schizoid
can be very defensive
bizare, eccentric, loners

25

cluster B personality d/o

antisocial, BPD, histrionic, narcissistic
dramatic, erratic, egocentric

26

cluster C personality d/o

OCPD, dependent, avoidant
avoidant, anxious, fearful

27

general dx criteria for personality d/o

2 or more effected (cognition, affectivity, interpersonal fx, impulse control)
pattern is stable and of long duration

28

criteria for conduct d/o

formal dx: 7-18 y/o
before 10 childhood onset
after 10 adolescent onset
greater than 18 meet criteria for ASPD

29

criteria for ODD

precursors: 3-7 y/o d/o: 8 y/o

30

criteria for autism

lack awareness of other; may tx them like objects
abnormal communication
repetitive behaviors
stereotypical movements

31

criteria for Rett's d/o

*affects only females
normal development until 5months;
onset 1 year old
-they cease to gain developmental milestones
-loss of skills already required
sterotypic hand movements
seizures, scoliosis and hypertonicity

32

criteria for asperger's d/o

like autism but *speech is not affected

33

criteria for ADHD

px in at least 2 settings
age criteria of 7 y/o

34

criteria for MR

code on axis II
IQ less than 70
mild 50-17 IQ
mod 35-50
severe 20-35
profound below 20
onset before 18 y/o

35

Fetal Alcohol Syndrome characterizations
(not coded in DSM IV)

Physical signs: skin folds in corner of eyes
low nasal bridge
short nose
**indistinct philantrum (groove between nose and upper lip)
**thin upper lip
small head circumference
small midface

36

What age populations most at risk for suicide?

Teens and older adults

37

What is the number one cause of suicide in teens?

depression
adolescents have a irritable mood more often than a sad mood

38

Assessing cluster A

pervasive distrust, suspiciousness, with odd unusual behaviors,
Paranoid personality, schizoid, schizoidtypal

39

Assessing cluster B

pervasive problems with relationships and affect/mood

borderline, histrionic, antisocial, narscistic

40

Assessing cluster C

pervasive anxiety, fear

avoidant, dependent, obsessive

41

what is personality

emotional, cognitive and behavioral attributes of a person
-enduring pattern of precieving reality and thinking about things
-ingrained and developed early but can be altered

42

what is egosyntronic

consistent with personality; it is behavior based on personality that is comfortable

43

what is egodystonic

incosistent with personality; it is behavior based on personality that is uncomfortable

44

When does abstract thinking develop

greater than age 12

45

Time frame for oppositional defiant disorder

6 months and greater

46

childhood onset for CD is...

before age 10 is childhood
after age 10 is adolescent

47

Neurotransmitters in ADHD

DA and NE

48

brain region in ADHD

PFC, basal ganglia, and RAS (reticular activating system)

49

Substance abuse

has to maladaptive
has to cause problems and they still use the substance
has to be 12 months

50

substance dependence

cognitive, behavioral, physiological sx

51

addiction

has to be 12 months

52

Delerium Tremens

first 24-72 hours (1-3 days)
n/v, sweats, tremors, tactile distrubances, anxiety, agitation, visual and auditory disturbances, HA, altered sensorium

53

CIWA scores

mild w/drawal 0-8
mod 9-15
severe greater than 15
max score 67

54

substance abuse
drugs used for cravings

naltrexone
acomporosate
ondansetron
buprenophrine

55

Aversive treatment in substance abuse

disulfram (Antabuse)
*need to be alcohol free for at least 12 hours and anything with alcohol in like mouthwash for up to 2 weeks after stoping med
*monitor liver
*can induce mania

56

etiology of substance related disorders
reinforcement

brain based on changes to structure and fx
-positive rewards result in social rewards commonly associated with drug use such as euphoria and is mediated by DA pathways
-negative rewards are aversive such as anxiety and depression mediated by GABA pathways
-reinforcement occurs in the ventral demential area in nucleus accumbent (reward center)
-DA relased and further release of neuropeptides this enhances pleasure experience and with repeated use DA system becomes sensitized and eventually associated with stimuli (like pics of the drug)

57

Neuroadaptation related to substance abuse

this is how tolerance and withdrawal occur. changes can be enduring for years causing increased risks for relapse. it explains how you can pick up a drink after years of sobriety and have same level of tolerance and physical impact.

58

the most commonly abuse illegal drug

marijuana

59

the most commonly abuse legal drug

alcohol

60

CAGE scoring

2 or more indicate clinically significant and risk for dependency

61

Psychotropics

are lipophilic, extensively metabolized in liver though phase of oxidative reactions phase II glucuronide conjugation and evolve changes in CYP450 monooxygenases

62

CYP system

-superfamily of isoenzymes located in endoplasmic reticulum mainly in liver
-isoenzymes responsible for oxidized metabolism and exonbiotics as well as endogenous compounds like prostaglandins, fatty acids, steroids
-CYP enzymes classified by amino acid sequence
-the # is "family" which over 4j0% identify with family members and # is equal to individual isoenzyme
-major CYP enzymes in metabolism of drugs: families 1 2 3 with the isoforms CYP1A2, 2C9, 2C19, 2D6, 3A4
-each CYP isoform is specific gene product-family genetics but effected by environment

63

Delirium

is a syndrome not disease
subtypes (hyperactive, hypoactive, mixed/cycles)
screening tool CAM confusion assessment method

64

Hallmark s/s of AD

amyloid plaques, neurofibillary tangles
genetically autosomal dominant
decrease in Ach and NE

65

Hallmark s/s of VD

carotid bruits, fundoscopic abnormalities, enlarged cardiac chambers

66

Hallmark s/s of HIV dementia

parenchymal abnormalities on MRI
*caution with drug interactions between Antivirals and Antipsychotics

67

Hallmark s/s of frontotemporal dementia

gliosis, picks bodies
*changes in personality

68

Hallmark s/s of Creutzfeldt-Jakob dementia

fatal, rapid

69

Hallmark s/s Huntington's dementia

subcortical and mostly motor abnormalities

70

Hallmark s/s Lewy body

lew inclusion bodies in cortex (protein bodies)
*recurrent visual hallucinations
*adversely react to antipsychs

71

amaurosis fugax

unilateral vision loss, curtain over eye

72

Namenda

10-20mg
N-methyl-D-aspartate glutamate receptor antagonist
*prevents over excitation of glutamate and promotes synaptic plascticity

73

cholinesterase inhibitors

for mild to mod dementia
aricept 5-10 mg
rivastigmine (exelon) 1.5-6mg BID for AD and PD
transdermal 9.5 daily

74

what does psychotic mean

inability to test reality

75

mesolimbic

limbic system
info processing
**Where positive sx arise in schizo

76

mesocortical

frontal cortex
attention, concentration, executive fx
**where negative sx arise/cognitive sx in schizo

77

catatonia

motor sx
immobility-catalepsy
OR
excessive purposeless movement

78

soft signs of schizo

1. astenognosis (loose ability to judge the shape of object by touch)
2. twichtes, tics, rapid eye blinking
3. dysdiadochokinesia (impairment of ability to perform rapidly alternating movements
4. impaired find motor movement, left-right confused
5. mirroring

79

astenognosis

loose ability to judge shape of object by touch
parietal lobe px

80

dysdiadochokinesia

impairment to perform rapidly alternating movements
cerebellum px

81

Hard signs in schizo

1. weakness
2. decreased reflexes

82

How anti psychos work on DA pathways

mesolimibic - decrease positive signs by blocking DA
mesocortical - decrease negative signs by increasing DA
nigrostriatla - block 5HT which causes DA to increase and Ach to decrease and prevent or decrease chance of EPS
tuberoinfundibular - DA inhibit prolactin

83

The higher the potency of blocking DA....

the increased risk of EPS
(DA and Ach are inversely related...so decreasing DA will increase Ach)

84

The lower the potency of blocking DA...

the less risk of EPS

(decrease DA you increase Ach; inversely related)

85

What does caffeine and nicotine do to antipsychotics?

they decrease the concentration/effects of the antipsychotic meds

86

neuroleptic malignant syndrome labs

increase CPK, WBC, LFT

87

treatment for neuroleptic malignant syndrome

dantrolene
bromocriptine
*stops the blocking of DA
antipyretic for hyperthermia or cooling blanket
hydration
BZD for catatonic sx

88

What is the black box warning on antipsychotics in older adults?

they can increase risk of mortality in older adults with dementia

89

schizophrenia time frame

greater than 6 months

90

schizophreniform time frame

less than 6 months and may not have impairments in fx

91

erotomanic

delusion focused on false belief that another is in love with them
usually spiritual or famous
usually stalking

92

brief psychotic d/o lasts...

1 day and less than 1 month

93

theories in anxiety d/o

freud-psychodynamic: anxiety initially from experiences from birth; conflict with id and superego; increase use of defense mechanisms

sullivan-interpersonal: px between interpersonal relationships and self becomes identified by our we perceive others to view us

neurobiological: px with limbic, midbrain, and areas of cortex; HPA axis, autonomic response; decrease levels of GABA, (GABA and 5HT suppress HPA axis)

94

cyclothymic d/o

similar to bipolar but less severe
-hypomania and dysthymia sx
-risk developing BP disorder

95

depolarization

initial phase, excitatory, Na and Ca in

96

repolarization

restore phase, inhibitory, K leaves

97

potency

dose required to cause effect

98

therapeutic index

level where desired effect is achieved and below level of toxicity
*margin of safety with high index
*low index low safety margin

99

tachyphylaxis

acute decline in therapeutic response

100

Ch level

98-106

101

k level

3.5-5.1

102

thyroid fx

t3 t4 bind small amount to protein
*free T4 0.8-2.8 normal
used to evaluate hypo or hyper (can be increase in methadone and decreased in propranolol)
TSH-evaluate hypo; values can be increased with lithium
-hypo: decreased T4 increased TSH
-hyper mimics bipolar d/o

103

Ca level

8.8-10.5
-increased in children that are growing
-increased by lithium, it D, thiazides, antacids
-decreased in anticonvulsants, steroids, oral contraceptives
-increase excite and decrease depress

104

Na level

135-148
imbalance-water distribution, seizures, heart and bp rate, HA LOC changes

105

Mg level

1.3-2.1
decrease depress, irritable, weakness
increase n/v weakness

106

ALT

5-35
acts as catalyst in amino acid production
with liver damage level may rise as much as 50x normal (1750)
pronounced >300 disease and damage
mod 100-300 muscle injury (trauma, seizures, infection,
injections), biliary obstruction, CHF, MI, burns
Drugs: tylenol, carbamazepine can increase

107

AST

5-40
most are in skeletal muscles
increased with tissue damage
pronounced >5x normal (200)
acute liver damage, MI, shock, acute pancreatitis, mono
mod 3-5x normal (120)
biliary, cardiac, CHF, liver tumor, chronic hepatitis
slight 2-3 x normal (80)
pulmonary infarct, DT's, CVA, cirrhosis

108

GGT

10-38
isoenzyme of alkaline phosphatase
monitor level with alcohol abuse
mod increase in cirrhosis, pancreatitis, renal disease

109

theories in MDD

psychodynamic: object loss (early losses in childhood effect us later)
aggression turned inward (Frued): loss in childhood causes anger and turns inward to decrease self esteem and cause guilt
learned helplessness-hopelessness: lack of control

biological theory: genetic predisposition
endocrine dysfx: HPA axis-neurovegatitive sx; increase cortisol results in changes in brain; abnormal transmitors or decrease in tryptophan/5HT; decrease volume of hippocampus, PFC, limbic

110

Bereavement

occurs if depression sx are within 3 months of major loss/death
self esteem usually preserved

111

How do you treat HTN related to MAOI ?

give phyntolamine which binds to NE receptor sites and blocks NE

112

What personalities are associated with dysthymic d/o

cluster B
antisocial, BPD, NPD, dependent, histrionic

113

Theories in bipolar

biological: GABA dysregulation, increase NE/adrenergic, voltage gate px
kindling: brain becomes sensitive to electrical stimuli misfiring

114

Lithium level
SE
toxicity

0.5-1.2
SE: wt gain, thyroid and parathyroid dxfx, hand tremors, GI upset, acne, edema, tubular changes, leukocytosis
Toxicity: slurred sjpeech, confusion, severe GI effect
-monitor kidneys, NSAIDS and ACEI can increase levels
*gold standard for mania, depression and SI
response 1-2 wks
routine lab: CBC, Renal, thyroid, lithium levels
*want to ask about pregnancy (Epstein bar)

115

depakote

gold standard for rapid cycling
labs routine (CBC, liver, depakote levels)
*ask about pregnancy (spina bifida)

116

black cohosh

good in menapuase sx and prementraul sx

117

belladonna

anxiety

118

catnip

sedation

119

chamomile

sedation, anxiety

120

ginkgo

delerium, dementia, sexual dysfx caused by SSRI

121

ginseng

depression, fatigue

122

valerian

sedation

123

Yalom

group therapy

124

10 concepts of group therapy

install hope
alturism
socializaiton
interpersonal learning
catharsis
corrective refocusing
universality
imitative behavior
group cohesiveness
existential factors

125

group phases

forming
storming (resistance)
norming
performing
adjourning

126

family system concepts

system-units/structure
all operate together
need to understand all parts

127

Bowen

family systems therapy

128

Minuchin

structural family therapy
how px are created with relationships of others px/sx are rated in family patterns
structural mapping/genogram

129

Satir

experiental therapy
px determined by personal experience

130

deShazer and OHanlon and Berg

solution focused therapy
miracle questions
exception finding
sclaing

131

omega 3

ADHD, dementia, MCI,
interacts with warfarin and increases its effects

132

sam e

depression, OA, liver disease
may cause hypomania, hyperactive muscles and possible seratonin syndrome

133

vitamin e

immune system, neuro d/o
can increase effects of warfarin and anti platelet drugs and increase statins

134

melatonin

insomnia, jet lag, shift work, CA
ASA, NSAIDS, beta blockers, steoids alcohol interacitons
can inhibit ovulation in large doses

135

fish oil

BP, HTN
warfarin ASA, NSAIDS, ginkgo, garlic, may alter glucose regulation

136

psychoanylytical

frued
for gaining insight

137

cognitive

Aaron Beck
events don't cause anxiety ppl perceptions cause anxiety

138

behavioral

Lazarus
change behavior through exposure, relaxation, px solving, role playing

139

DBT

Linehan
BPD

140

existential

Frankl
person centered
self directed growth
self actualization

141

interpersonal

Kleman Weissman
focus on present

142

EMDR

Shapiro
form of behavior therapy
bilateral stimulation

143

Schedule 1 drugs

non medicinal substances
high abuse potential
research

144

schedule II drugs

high potential abuse
drugs in current use
NO telephone orders and NO refills
(Morphine, codeine, fentanyl, methadone, oxy)
ADHD meds/stimulants

145

schedule III drugs

potential for abuse
telephone order IF followed by written
must be renewed every 6 months
refill limited to 5
testosterone, butalbital

146

schedule IV drugs

darvon, tawlin, BZD
can only be refilled up to 5 x or after 6 months

147

schedule V drugs

with lowest potential for abuse
handled same as non schedule drugs

148

Pregnancy category

A-controlled studies show no risk
B-no evidence of human risk
C-risk cannot be ruled out
D-positive evidence of risk
X-C/I in pregnancy

149

teratogenic: depakote

spina bifida

150

teratogenic: lithium

epstein anomaly

151

teratogenic: carbamazepine

neural tube defects

152

teratogenic: BZD

floppy baby syndrome, cleft palate

153

agraphesthesia

unable to recognize letters drawn on hand

154

physical assessment
romber

testing equillibrium
px with cerebellum or vestibular dysfx

155

epidemiology

study at distribution, inclusion, and prevalence and duration of disease

156

incidence rate

number of cases occurring over specified time (usually 1 year)

157

prevalence rate

number of existing cases at a specified time

158

structural and functional imaging

functional MRI, 3D MRI,
mostly used for research

159

functional imaging

assess bold flow and may use radioactive to cross blood brain barrier
used in research
EEG and evoked potential testing
MEG
SPECT

160

structural imaging

gives evidence of size and shape of anatomy structures
CT (3D view)
-easy, inexpensive, see structures based on density, but cannot view structures close to bone, underestimate brain atrophy
MRI (2D image)
-view structures close to bone, separate white and gray matter, readily available but expensive, and many CI like pacemaker, implants and ventilators

161

monoamines/catecholamines

DA, NE

162

locus creels of pons
precursor tyrosine

NE

163

adrenal glands

EPI

164

substatia nigra and ventral tegmental area
precursor tyrosine

DA

165

raphe nuclei
precursor tryptophan

SE

166

Amino acids
excitatory

glutamate
aspartate

167

amino acids
inhibitory

GABA
Glycine

168

amino acids
Ach
cholinergic
produced....

produced by basal nucleus of meynert
precursor acetylcoenzyme A and choline

169

neuropeptides
non-opiod like substance P, somatostatin
opiod like endorphins, enkephalins, dynorphins
modulate...

modulate pain,
a decreased amt thought to cause substance abuse

170

Sullivan

interpersonal theory
once concept is on drives
what drives us (sex drives, security, satisfaction)

171

Maslow

hierarchy of needs

172

psychoanylytical
all behavior has meaning

Frued

173

behavior of determinism

Frued
it is activated by unconcious or mental content

174

oral phase

0-18months

175

anal phase

18m-3 yr

176

phallic

3y-6 yr

177

latency (social/relationships)

6 yr-puberty

178

genetial puberty

puberty and beyond

179

Bandura

social learning
self efficacy
ppl learn from observing/role modeling
bobo doll

180

Leininger

theory of cultural care
nursing theory

181

Peplau

based on sullivan
interpersonal theory
phases of nurse relationship: orientation, working, termination

182

Watson

caring theory
nursing theory

183

transtheroetical model of change

precontemplation- no intention to change

contemplation- thinking about change

preparation- ready to change

action-they change

maintenance- engage in change and prevent relapse

184

Piaget

cognitive theory
human development is from cognitive, learning and comprehending
stages: sensorimotor, preoperational, concrete

185

Piaget
sensorimotor

birth-2
object permanence

186

piaget
preoperational

2-7 yr
symbolism, magical thinking

187

piaget
concrete operations

7-12 yr
concepts
reversibility (ice to water)
conservation (shape may change but still same: clay)

188

Id

primary drives,
unconscious

189

ego

external reality, rational
defense mechanisms

190

super ego

right vs wrong
guilt vs shame
develop by age 6

191

reaction formation

overcompensate, display opposite feelings

192

undoing

try to make up for behavior

193

sublimation

unconscious
substitute acceptable behavior for strong unacceptable behavior

194

Erickson
infancy

0-1 yr
trust vs mistrust

195

erickson
early child

1-3 yr
autonomy vs shame and doubt

196

erickson
late child

3-6 yr
initiative vs guilt

197

erickson
school age

6-12 yr
industry vs inferiority

198

erickson
adolescents

12-20
identity vs role confusion

199

erickson
early adult

20-35
intamancy vs isolation

200

erickson
middle adult

35-65
generativity vs self absorption or stagnation

201

erickson
late adult

>65
integrity vs despair

202

probability

likelihood of event occuring

203

pvalue

level of significance
probability of particular result occurring by chance alone
(if p=.01 there is 1% probability of obtaining a result by chance alone)

204

t test

assess means of 2 groups to see if they are different

205

analysis of variance ANOVA

test 3 or more groups to see if they are different

206

pearson r

see the relationship between two groups

207

variance

how values are dispersed around mean

208

standard deviation

indication of possible deviation from mean

209

external validity

ability to generalize

210

internal validity

the extent you can say no other variables except the one you are studying caused the result

211

the highest level of evidence

systematic, meta analysis

212

lowest level of evidence

opinions, authorities or expert committees

213

hierarchy of evidence

highest
-systematic, meta analysis
-evidence from clinical practice guidelines
-one or more RCT
-controlled trials
-systematic review from qualitative and describtive study
-single descriptive or qualitative
-opinion, expert committees
lowest

214

justice

doing what is fiar

215

beneficience

promoting well being

216

nonmalfeasance

doing no harm

217

fidelity

being true and loyal

218

autonomy

do for self

219

veracity

tell truth

220

respect

treat you with equal respect

221

deontological theory

action judged as good or bad regardless consequences

222

teleological theory

action good or bad based on consequences

223

virtue ethics

actions chosen based on moral virtues or character of person making decision

224

duty

NP had duty to exercise reasonable care=standard

225

breach of duty

violated standard of care

226

proximate cause

causal relationship between breach of duty and pts injuries

227

damages

permenant substantial damage as result of breach in duty

228

primary prevention

prevent dx

229

secondary prevention

decrease prevalence of mental d/o, early case finding, screening, prompt, effective tx

230

tertiary prevention

decrease disabilities associated with mental d/o
rehab, tx programs

231

asperger

No delay in language
delay in motor sometimes
sustained px in social
repetitive movements, behaivors

232

rett syndrome

develop specifid deficits after a normal developmental period
primarily in girls
can have decelerated head growth between 5months and 48 months
loose previously acquired skills 5-30months
lose social, poor coordination, stereotypal movements, motor slowing

233

ASD

marked impairment in social, cognitive by age 3
communication delay, unable to sustain or initiate convo, repetitive behaviors, inflexible, short attention, app and sleep px, self injurous behavior, no imaginary plan, no peer play,

234

russel's sign

callouses on hands from purging

235

FDA approved drug for bulimia

fluoxetine

236

MR
onset

less than 18 yrs
IQ less than 70

237

mild MR

50-70
6th grade level

238

mod MR

35-55
2nd grade level

239

severe MR

20-40
poor motor, little or no speech

240

profound MR

less than 20
minimal sensorimotor fx
poor cognitive social
often no speech

241

stage I of sleep

NREM transition from wake to sleep 5% of cycle

242

state II of sleep

NREM 50% of cycle

243

state III and IV of sleep

NREM slow wave
deepest level
20-25% of cycle
occur in first 1/3 or 1/2 cycle

244

REM cycle sleep

cyclical throughout night alternating with NREM ever 80-100min usually

245

insomnia

inability to get enough sleep needed to fx during day

246

transient insomnia

jet leg, stress, hotels

247

short term insomnia

bereavement, stress
may last up to 3 weeks

248

long term insomnia

greater than 3 weeks