Exam 5 Mental Health Flashcards Preview

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Flashcards in Exam 5 Mental Health Deck (239):
1

2 or more people who develop an interactive relationship and share at least on common goal or issue

Therapeutic groups

2

When members recognize they are not alone, other members have similar thoughts, feelings, & problems

Universality

3

When you help others

Altruism

4

When you have accurate info shared

Imparting of information

5

Treatment intervention in which a trained leader establishes a group for the purpose of treating pts with psychiatric disorders

Group psychotherapy

6

Corrective recapitulation of the primary family group

Reenact & connect family values

7

catharsis

sense of relief

8

maintenance group re-enforce or help maintain good behavior

support groups

9

name the types of activity groups

recreational
creative

10

what do educational groups help with

give pts information about medications, coping skills, social skills etc

11

family becomes involved with therapy

family therapy

12

what are the goals of family therapy

understanding family dynamics
mobilize family strengths & resources
restructure maladaptive family behavioral styles
help strengthen family problem solving behaviors
assess and treat family and patient

13

Freud

father of psychology
first to identify personality development by stages, the first 5 years are the most important, all mental disorders stem from issues from childhood that weren't involved

14

Levels of awareness

conscious
preconscious
unconscious

15

material within awareness is only a small part of the mind

conscious

16

refers to memory that can be recalled to consciousness with some effort

preconscious

17

all the memories, conflicts, and experiences that have been repressed and cannot be recalled at will without assistance of a therapist

unconscious

18

cannot tolerate frustration, lacks ability to problem solve, "pleasure principle", at birth we are all Id, source of all drives, instincts, needs, genetic inheritance

Id

19

rational self, provides logic & reason, problem solver, and reality tester, strives to maintain harmony
"reality principle"

Ego

20

represents moral component, last to develop, concerned with right and wrong, opposite of Id

superego or conscience

21

what side of the brain is conscious mind, logic, reason, math, reading, writing, language, analysis, Ego

left

22

what side of the brain is unconscious mind, imagery, creativity, synthesis, dreams, symbols, emotions, Id

right

23

why does the ego develop defense mechanisms?

to deal with anxiety by preventing conscious awareness of threatening feelings, we cant survive without them

24

covering us a real or perceived weakness by emphasizing a trait one considers more desirable

compensation

25

refusing to a acknowledge the existence of a real situation or the feelings associated with it

denial

26

transfer of feelings to another that is considered less threatening or that is neutral

displacement

27

an attempt to increase self worth by acquiring certain attributes and characteristics of an individual one admires

identification

28

an attempt to avoid expressing actual emotions association with a stressful situation by using the intellectual processes of logic reasoning and analysis

intellectualization

29

attributing feelings or impulses unacceptable to ones self to another person

projection

30

attempt to make excuse or formulate logical reasons to justify unacceptable feelings or behaviors

rationalization

31

preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opp. thoughts or types of behaviors

reaction formation

32

responding to stress by retreating to an earlier level of development and the comfort measures associated with that level of functioning

regression

33

involuntary blocking unpleasant feelings and experiences from ones awareness

repression

34

rechanneling of drives or impulses that are personally or socially inacceptable into activities that are constructive

sublimation

35

a voluntarily blocking of unpleasant feelings and experiences from ones awareness

suppression

36

symbolically negating or canceling out an experience that one finds intolerable

undoing

37

occurs when emotional conflict or stressors are handled by attributing negative qualities to self or others. when devaluing another, the individual appears good by contrast

devaluation

38

Eriksons developmental theory stages of personality development

emphasis on stages of development, each stage is an emotional crisis, degree of mastery is related to the degree of maturity that the adult achieves, 8 stages

39

views abnormal behavior as part of a disease

neurobiological model

40

cerebrum

largest part of brain, associated with thought and action, divided into 4 sections called lobes

41

frontal lobe

reasoning, planning, parts of speech, movement, emotions, problem solving

42

parietal lobe

associated with movement, spatial orientation, recognition, perception of stimuli

43

occipital lobe

associated with visual processing

44

temporal lobe

associated with perception and recognition of auditory stimuli, memory, and speech

45

limbic system

"emotional brain", found in the cerebrum, regulates emotion and memory. connects the lower and higher brain functions, influences motivation, mood, sensations of pain and pleasure

46

parts of limbic system

thalamus
hypothalamus
cingulate
amygdala
hippocampus
basal ganglia

47

all sensory inputs through it to the higher levels of the brain

thalamus

48

sits at the top of the brainstem, while small, it controls autonomic nervous system center for emotional response and behavior, regulates body temperature, food intake, water balance, and thirst, and controls endocrine system

hypothalamus

49

serves as a conduit of messages to and from the inner limbic system

cingulate

50

appears to be responsible for the influence of emotional states on sensory inputs

amygdala

51

important in the transition of information from short term to long term memory

hippocampus

52

plays a role in planning and coordinating motor movements and posture

basal ganglia

53

acetylcholine

voluntary movement, learning, memory and sleep
too much=depression
too little=dementia

54

dopamine

correlated with movement, attention, and learning
too much=schizophrenia
too little=Parkinson's disease

55

norepinephrine

associated with eating, alertness
too much=schizophrenia
too little=depression

56

epinephrine

involved in energy and glucose metabolism
too little=depression

57

serotonin

plays a role in sleep, mood, appetite, and impulsive aggressive behavior
too little=depression, anxiety disorders (esp. OCD)

58

GABA

inhibits excitation and anxiety
too little=anxiety,

59

endorphins

involved in pain relief and feelings of pleasure and contentedness

60

voluntary patients

patient or guardian applies for Tx and can sign out of Tx

61

involuntary patients

mental illness is not incompetent, state must prove mentally ill and dangerous

62

evaluation and emergency care (involuntary tx)

72 hours, those who are dangerous to self or others or gravely disabled

63

certification for observation and tx (short term)

14 days, psychiatrist must see in 24 hours, disorder must be treatable, probable cause required by 4 amendment (search and seizure)

64

extended or indeterminate commitment (long term)

need prolonged care but refuse voluntarily. 3, 6, 12 months. requires a court hearing

65

hospital based care

short term, crisis intervention & safety, D/C planning, psychotherapeutic management model

66

outpatient

mental health clinics, private practices, primarily for counseling

67

partial programs

day program, structured activity, and tx during the day, pt returns to home in evening

68

residential services

(stokley center) extended care facilities, group homes, halfway homes, living programs, shelters

69

eustress

good stress

70

something that triggers stress to be real or perceived

stressor

71

natural stimulant made in adrenal gland, epinephrine, affects ANS (increase of HR, pupils dilate, sweat) fight/flight response

adrenalin in action

72

alarm triggers response; body reacts; return to homeostasis

alarm and adrenaline

73

results in higher than normal amounts of adrenaline; adrenaline overload takes a toll on the body (insomnia, nausea, dizziness, depression)

prolonged stress

74

name general stress reduction techniques

relaxation, reframing, sleep, exercise, decrease caffeine

75

persistent re experiencing with a highly traumatic event that involves actual or threatened death or serious injury to self or others

post traumatic stress disorder

76

when do Sx of PTSD usually appear

3 months after trauma but a delay of months or years is not uncommon

77

a dissociative experience during which the event is relived and the person behaves as though he/she is experiencing the even t at that time

flashbacks

78

what are the major features of PTSD

flashbacks, persistent avoidance, numbing of general responsiveness (diff sleeping, concentrating, hyper-vigilance)
difficulties with relationships, trust, child/spouse, chemical abuse

79

occurs within one month after exposure to a highly traumatic event, such as those as PTSD

acute distress disorder, must display 3 dissociative sx either during or after the traumatic event, if it resolves within 4 weeks its acute distress disorder, if it persists then it is PTSD

80

name the dissociative sx of

sense of numbness, detachment, reduced awareness of surroundings, de-realization, depersonalization, dissociative amnesia

81

a feeling of anticipation, generally unpleasant

anxiety

82

abnormal anxiety

remains when the danger or stressors are gone

83

mild anxiety

can id things that are disturbing and are producing anxiety, slight discomfort, restlessness, impatience, foot or finger taping, lip chewing, fidgeting, able to work effectively toward a goal and examine alternatives

84

moderate anxiety

has narrow perceptual field, grasps less of what is going on, able to solve problems but not at optimal ability, voice tremors, shakiness, diff concentrating, somatic complaints (urinary freq. urgency, HA, insomnia) increase HR, RR, pacing, banging hands on table

85

severe anxiety

has greatly reduced perceptual field, attention is scattered, absorbed with self, unable to see connections between events or detains, has distorted perceptions, feelings of dread, confusion, sense of impending doom, hyperventilation, tachycardia, loud and rapid speech, threats and demands

86

panic

unable to focus on environment, experiences the utmost state of terror and emotional paralysis, may have hallucinations or delusions that take the place of reality, may be mute or extreme psychomotor agitation, experience of terror, immobility or severe hyperactivity or flight, severe shakiness, sleeplessness, out of touch with reality

87

primary method that our ego uses to control or manage anxiety

defense mechanisms

88

what is the most common form of psychiatric disorder in US

anxiety

89

etiology of anxiety

genetic, limbic system, neurotransmitters, behavioral/cognitive (learned behavior)

90

how does the cingulate act in anxiety

part that is associated with anxiety disorders, stores memories, emotions

91

how does the frontal cortex act in anxiety

interprets initial threat (threat or not)

92

how does the hypothalamus act in anxiety

activates fight or flight response

93

how does the amygdala act in anxiety

registers fear responses and stores it

94

how does the hippocampus act in anxiety

memory related to fear

95

serotonin in anxiety

level is decreased which causes anxiety

96

what is usually given for anxiety

Benzodiazepines

97

panic attack

sudden onset, feelings of terror, "out of blue" fear of losing control, feels like having heart attack

98

S/sx of panic attack

CP, palpations, diff. breathing, N/V, hot flashes, chills, feels like choking

99

intense excessive anxiety or far about being in places or situations from which escape might be difficult or embarrassing

panic attack with agoraphobia

100

irrational fear of an object or situation that persists although the person may recognize it as unreasonable

phobias

101

need to control themselves, others, and environment

obsessive compulsive disorder

102

thoughts, impulses or images that persist and recur so that they cannot be dismissed from the mind, can cause extreme anxiety

obsession

103

ritualistic behaviors an individual feels compelled to perform to reduce anxiety

compulsion

104

excessive collecting of items, failure to discard excessive amounts of these items, usually associated with OCD

hoarding

105

excessive worrying and anxiety about numerous things lasting 6 months or longer

generalized anxiety disorder

106

Sx of generalized anxiety disorder

restlessness, fatigue, poor concentration, irritability, tension, sleep disturbance

107

substance induced anxiety disorder is characterized by sx of

anxiety, panic attacks, obsessions, compulsions that develop with the use of a substance or within a month of stopping use of the substance involved

108

used for disorders in which anxiety of phobic avoidance predominates but the symptoms don't meet full diagnostic criteria for a specific anxiety disorder

anxiety disorder not otherwise specified (NOS)

109

SSRI

antidepressants
serotonin reuptake inhibitors
ex. Paxil, Prozac, Zoloft
don't use with ETOH, may take 4-6 wks to realize full benefit, don't stop suddenly

110

why are SSRI's not given to bipolar pts

bc they can cause manic episodes

111

SSNRI

serotonin norepinephrine reuptake inhibitors
ex. Cymbalta, Effexor

112

Anxiolytics (antianxiety)

Benzodiazepines
potentiate GABA decrease neuronal excitability, short term basis bc of dependence, produces calm effect
no ETOH, don't stop suddenly, don't take if prego, no caffeine
Ex. Ativan, valium, Xanax, Klonopin

113

Beta blockers

propranolol
used for GAD or panic, blocks beta adrenergic receptors in sympathetic NS causing a relaxation response

114

BuSpar

antianxiety
doesn't cause dependence
need 2-4 wks to reach full effect, long term Rx, should be taken regularly
SE: HA, dizziness, lightheadedness, nauseas, insomnia

115

Kava Kava

causes liver toxicity

116

valarian

root, put in tea, causes HA, dizziness, N/V

117

the expression of psychological stress through physical symptom, convert anxiety into physical symptoms, not caused by substance, possible link to repressed anxiety

somatoform disorders
usually obsessed on how their body is working/effected
"hysterical neurosis"

118

what is the prevalence of somatoform disorders

est. 30% mostly female

119

etiology of somatoform

not genetic, but runs in families, pain is r/t repressed anxiety, learned from environment, cognitive: focus on body sensations & misinterpret their meanings

120

intentionally produced physical or psychological s/sx to assume the sick role, no intent for economic gain

factitious disorder (not a somatoform disorder)
*most severe form is Munchausen syndrome

121

conscious effort to produce symptoms for benefit, usually for economic gain (disability), difficult to prove or disprove, often medication seeking

malingering disorder (not a somatoform disorder)

122

syndrome of multiple somatic complaints that cannot be explained medically and are associated with psychosocial distress and long term seeking of assistance from healthcare professionals

somatization disorder

123

characteristics of somatization disorder

vague, dramatized, exaggerated, report significant distress, anxiety & depression in history, report being ill for prolonged time with variety of Sx, chronic and relapsing pain, suicide threats and attempts are not uncommon

124

prevalence of somatization disorder

females, lower educational levels, rural areas, non white

125

Sx of somatization

pain*, GI* (N, V, D), sexual sx (irreg. period, ED), neurological (paralysis, numbness)
*most common

126

pain in one or more anatomic sites, causes clinically significant distress or impairment in social, occupational, or other important areas of functioning, anxiety usually triggers the pain, not intentionally produced

pain disorder

127

characteristics of pain disorder

frequent visits to MD to obtain relief, excessive use of analgesics, requests for surgery, Sx of depression, dependence on addictive substances

128

an unrealistic or inaccurate interpretation of physical sx or sensations, leading to preoccupation and fear of having serious illness

hypochondriasis

129

characteristics of hypochondriasis

over exaggeration, fear of disease/illness, preoccupation with sx, extreme worry, refuse to see mental health professional, chronic & relapsing, sx worsen with stress, convinced not receiving good care, MD shopping, OC traits, read about disease or hear about someone they know with the disease and causes alarm on their part

130

loss of or change in body function resulting from a psychological conflict, the physical sx of which cannot be explained by any known medical disorder or pathophysiological mechanism. Ex. blindness, numbness, loss of hearing

conversion disorder (very rare)

131

La belle indifference

lack of concern, often a clue to MD that the problem may be psychological rather than physical, affect voluntary motor or sensory functioning suggestive of a neurological disease, pseudoneurologial (seizures, paralysis, anosmia, pseudocyesis), not fabricated

132

prevalence

more common in females

133

commonly seen in community, psychiatric, cosmetic surgery and dermatological settings

body dysmorphic disorder

134

prevalence with body dysmorphic disorder

common in women, usually have OCD, may avoid work/school, low self esteem, commonly involves face

135

what is the primary gain for a pt with somatoform disorder

conversion sx enable the individual to avoid difficult situations or unpleasant activities about which he/she is anxious
(get out of something they don't want to do)

136

what is the secondary gain for a pt with somatoform disorder

gaining attention or support not otherwise forthcoming

137

what is the communication style for a pt with a somatoform disorder

hard time talking about feelings, but they can talk about their S/Sx, always focus on physical, become dependent on Rx to relieve the anxiety

138

Key point about somatoform disorder symptoms

not intentional or under the conscious control of the PT, unlike factitious disorders

139

what is the hallmark of dissociative disorders

disturbances in the normally well-integrated continuum of consciousness, memory, identify, and perception

140

unconscious defensive mechanism to protect the pt against overwhelming anxiety

dissociation

141

prevalence of dissociative disorders

rare, occur at any age group , often seen in military or POW camps

142

etiology of dissociative disorders

unknown but r/t stress (traumatic events)
limbic system is involved, traumatic memories are processed through limbic system and stored in hipocampus

143

persistent or recurrent alteration in PERCEPTION OF THE SELF while reality testing remains intact

depersonalization disorder

144

reality testing

oriented to person, place and time (not hallucinating)

145

depersonalization/derealization disorder is characterized by

fell mechanical or dreamy, sense of unreality slow movement, detached from body, may see oneself from a distance or outside of the body, may perceive limbs to be larger or smaller than normal

146

persistent or recurrent experience of UNREALITY OF SURROUNDINGS while reality testing remains intact, often dream like, or disoriented in familiar surroundings

derealization

147

an inability to recall important personal information, usually after a severe physical or psychological stressor, too pervasive to be explained by ordinary forgetfulness not due to substance use or neurological or medical condition

dissociative amnesia

148

types of dissociative amnesia

localized: selective, continuous, generalized

149

inability to recall incidents associated with traumatic events for a specific time period following the event, usually few hours or days, most common

localized dissociation amnesia

150

inability to recall only certain incidents associated with traumatic event for a specific period after the event

selective dissociation amnesia

151

inability to recall events occurring after a specific time up to and including the present

continuous dissociation amnesia

152

not being able to recall anything that happened during the individual entire lifetime, including his/her identity

generalized dissociation amnesia

153

behaviors of dissociative amnesia

appears alert, clouding of consciousness, often brought to ED by police who find them wondering & confused, onset follows severe psychosocial stress, termination is abrupt followed by full recovery, recurrences are unusual

154

sudden unexpected travel away from the customary locale and inability to recall ones identity and information about some or all of the past

dissociative fugue

155

behaviors of a pt with dissociative fugue

contacts with others are minimal, assumed identity, don't behave normally, often picked up by police, present to ED, able to provide details of their earlier life situation but have no recall from the beginning of the fugue state, duration is brief, recovery is rapid & complete, recurrence is not common, excessive alcohol use

156

most severe form of dissociative disorders and formerly known as multiple personality disorder, usually caused by severe psychological trauma (sex abuse)

dissociative identity disorder

157

prevalence of dissociative identity disorder

90% are women, uncommon

158

features of Dissociative identity disorder

alternate identities under stress, existence of at least 2 or more personalities in a single individual, only one personality evident at any given time, each personality (alter) is unique, transition from one alter to another is sudden, usually precipitated by stress, usually not aware of alters

159

if you have a pt that wakes up in a unfamiliar situation with no idea of how they got there, or who people are around them, what disorder might they have

dissociative identity disorder

160

what Tx options are available for pts with dissociative identity disorder

psychotherapy
hypnosis
creative art therapy

161

enduring patterns of perceiving, r/t and thinking about the environment

personality

162

what are the 4 biological humors

yellow-bile
black-bile
blood
phlegm

163

yellow bile

irritable and hostile

164

black bile

pessimistic and melancholic

165

blood

overly optimistic and extroverted

166

phlegm

apathetic

167

what axis is a personality disorder done on

axis 2

168

what are some characteristics of personality disorders

have problems with changes, unable to cope with stress, have difficulty responding flexibility and adaptively to the environment and to the changing demands of life, believe they are normal and others have a problem

169

reasons for relationship problems with pts with personality problems

blurring of boundaries, inability to trust, avoidance of fear or rejection, passive aggressive traits, have capacity to "get under skin"
Ex. Sam

170

etiology of personality traits

environment, genetics, abuse in childhood

171

prevalence

between 9-16%

172

Cluster A personality disorders

paranoid personality, schizoid personality, schizotypal personality

173

general characteristics of paranoid personality disorders

pervasive distrust and suspiciousness of others such that their motives are interpreted as spiteful, beginning in early adulthood and present in a variety of contexts, tense and irritable, notice rank and power

174

prevalence in paranoid personality

more common in men, but difficulty to known # bc most don't seek help with their problem

175

who maintains their self esteem by attributing their shortcomings to others

paranoid personality

176

etiology of the paranoid personality

environment, defense mechanism, r/t continuum with psychotic disorders such as schizophrenia

177

eccentric, isolated or lonely, profound defect in the ability o form personal relationships or to respond to others in any meaningful, emotional way

schizoid personality

178

characteristics of schizoid personality

classic loner, doesn't show much emotion, appear cold or indifferent to others, inappropriately serious about everything, often attached to animals

179

graver from of schizoid personality pattern, once described as "latent schizophrenics"

schizotypal personality

180

prevalence of schizotypal

common in females, 3% of population

181

characteristics of schizotypal personality

bizarre speech pattern, often unkempt, magical thinking, overly superstitious, isolated, excessive social anxiety, may talk to themselves

182

what can happen to a pt with schizotypal personality who is under stress

decompensate and demonstrate brief psychotic symptoms (delusional thoughts, hallucinations, bizarre behaviors, magical thinking)

183

etiology of schizotypal personality

schizophrenia spectrum and genetically linked, PET scans show structural changes of the brain

184

what structural changes in the brain are seen with schizotypal personalities

ventricular enlargement, volume reduction

185

behaviors described as dramatic, emotional, or erratic, pattern of socially irresponsible, exploitative, and guiltless behavior that reflects a general disregard for the rights of others

antisocial personality

186

Cluster B disorders

antisocial personality
borderline personality
narcissistic personality
histrionic personality

187

characteristics of antisocial personality

deceitful, manipulative, absent of remorse for hurting others, without conscious, feel entitled, not responsible for their actions, seductive, can be charming

188

etiology of antisocial personality

environment, genetic, often abused as children, as kids they are described as bully, have temper tantrums, don't respond to punishment, usually have substance abuse problems, cling (see others as all good or all bad)

189

characterized by a pattern of intense and chaotic relationships with affective instability, and fluctuating attitudes toward other people

borderline personality

190

prevalence of borderline personality

high mortality rate of 10%, extensive use of mental health services, 75% are women and victims of childhood sexual abuse

191

characteristics of borderline personality

don't tolerate being alone, frantic efforts to avoid real or imagined abandonment, cutters, impulsive with sex, spending, substance abuse, show separation anxiety, engage in splitting

192

etiology of borderline personality

rapprochement phase: 16-24 months, neg feedback from caregivers, sexual abuse

193

characterized by a persons grandiose sense of personal achievements

narcissistic personality

194

characteristics of narcissistic personality

consider themselves special, attention seeking, arrogant, takes advantage of others to achieve their goals, blames others for their problems, but they have a fragile self esteem, handle aging poorly

195

characterized by colorful, dramatic, and extroverted behavior, uncomfortable when not center of attention, will manipulate through their dramatic, charming, flamboyant, and sexually seductive behavior, shallow

histrionic personality

196

cluster C disorders

dependent personality
avoidant personality
obsessive compulsive personality

197

difficulty making everyday decisions without excessive advice and reassurance from others, need others to assume responsibility for most major areas of their life, believe they are incapable of surviving if left alone

dependent personality

198

characteristics of dependent personality

excessively clinging, self sacrificing, submissive, needy, gets others to care for him or her

199

what do you need to be aware of with dependent personality

countertransference

200

extremely sensitive to rejection which may lead to being socially withdrawn, want to be around people, but don't want to be judged so they withdraw

avoidant personality

201

characteristics of avoidant personality

avoids activities, unwilling to get involved with people unless certain of being liked, views self as being inferior, high levels of anxiety, most have social phobia, desires social interaction but fear of rejection

202

preoccupied with details, rules, lists, order, organization, or schedules to the point that the purpose of the activity is lost, perfectionist, inflexible, difficulty expressing emotions

obsessive compulsive personality

203

what are the most common defense mechanisms for OCD

rationalization, reaction formation, isolation, undoing

204

primary gain

avoiding

205

secondary gain

gaining something

206

terror of gaining weight, less than 85% of expected weight, appear emaciated

anorexia nervosa

207

name characteristics of anorexia nervosa

preoccupation with thoughts of food, views self as fat even when emaciated, peculiar handling of food, judges self worth by weight, terror of gaining weight, may have compulsive behaviors such as hand washing, may have rigorous exercise regimen, self induced vomit, laxatives

208

clinical presentation of anorexia nervosa

cachectic, lanugo, mottled, cool skin, low HR, BP, Temp

209

2 types of anorexia

restricting
binge/purging

210

during anorexia nervosa, the person has not regularly engaged in binge eating or purging behavior

restricting anorexia

211

has regularly engaged in binge eating or purging behavior

binge/purge anorexia

212

complications with anorexia nervosa

bradycardia, cardiac murmur, sudden cardiac arrest, leukopenia, , electrolyte imbalance

213

binge and purge, may not physically appear to be ill, often slightly above or below ideal body weight

Bulimia nervosa

214

binge eating behaviors

food consumed rapidly, usually terminated by self induced vomiting

215

what does self induced vomiting lead to

erosion of tooth enamel, dehydration, electrolyte imbalance and gastric/esophageal tears

216

what follows bingeing

self degradation and depressed mood

217

clinical presentation of bulimia nervosa

normal to slightly low weight, dental caries, tooth erosion, parotid swelling, gastric dilation, calluses on hand, EKG changes

218

Russell's sign

scars on hand from self induced vomiting

219

Bulimia criteria

at least twice a week for 3 months

220

regularly engages in self induced vomiting, or the use of laxatives, diuretics, or enemas

purging

221

regularly uses fasting or vigorous exercise but does not regularly engage in self educed vomiting, laxative use, diuretics, or enemas

nonpurging

222

what treatment is used for bulimia

long term cognitive behavioral therapy is most effective, Tx for co-existing depression, substance abuse, personality disorder, individual, group therapy

223

is there a medication specifically for anorexia nervosa

no

224

what labs would you do for anorexia nervosa

electrolyte, glucose, thyroid function tests, CBC

225

what is the first priority for anorexia nervosa

medical stabilization

226

at what % of weight below normal is immediate stabilization needed

75%

227

demands of replenished circulatory system overwhelm the capacity of a nutritionally depleted cardiac muscle, which results in cardiovascular collapse

refeeding syndrome

228

a single event affects unrelated situations

overgeneralization

229

reasoning is absolute and extreme

all or nothing thinking

230

the consequences of an event are magnified

catastrophizing

231

events are over-interpreted as having personal significance

personalization

232

subjective emotions determine reality

emotional reasoning

233

prevalence in bulimia nervosa

more prevalent than anorexia nervosa, 1.5% in women, 0.5% men, onset is late adolescence, occurs where thinness is emphasized

234

Etiology of eating disorders

altered brain serotonin, SSRI increased levels of serotonin do not improve mood sx until after an underweight pt has been restored to 90% of optimal weight

235

are eating disorders issues with food

no, based more on serious psychological problems

236

prevalence in anorexia nervosa

has increased, 1.0% in women, 0.3% in men, onset occurs early to middle adolescence females

237

enmeshment

boundaries between the members are weak, minimal privacy, interactions are intense

238

etiology of eating disorders

genetic, psychological (aversion to sexuality), learned behavior, controlling/enmeshment family, environment (western cultural ideal)

239

What medication is effective in relieving pain

SNRI'S