Human Development MNTH

Question 1

Define unconscious vs preconscious

Answer 1

Unconscious is a reservoir of thoughts and urges outside of conscious awareness

Preconscious are thoughts and feelings that a person is not currently aware of, but which can be easily brought up to the conscious level.

Question 2

Define Defense Mechanism

Answer 2

Unconscious strategies that people use to protect themselves from anxious thoughts or feelings

Question 3

Who came up with the idea of Defense Mechanisms, and who continued the work?

Answer 3

Sigmund Freud

Anna Freud considered defense mechanisms as automatisms of the individual. They arise during involuntary and voluntary learning

Bowin 2004: Had the idea that intelligence amplifies emotions, and can keep the psyche focused on repetitive thinking.

Question 4

Repression

Answer 4

Blocking difficult thoughts from entering the conscious

Question 5

Regression

Answer 5

Reverting back to the behavior or emotions of an earlier developmental stage when a person is anxious or stressed

Question 6

Projection

Answer 6

Having a socially unacceptable feeling and instead of facing it, the urge or feeling is seen or projected in the actions of other people.

(That girl is so into me, even when her back is to you)

Question 7

Reaction Formation

Answer 7

Behaving or expressing the opposite of one’s true feelings

Little man syndrome

Question 8

Sublimation

Answer 8

Positive Defense Mechanism

Channeling unacceptable urges into a productive outlet

Question 9

Denial

Answer 9

Refusing to recognize real facts or experiences that would lead to anxiety

Someone with substance abuse thinks they don’t have a problem

Question 10

Rationalization

Answer 10

Justifying a mistake or problematic feeling with seemingly logical reasons or explanations

Question 11

Displacement

Answer 11

Redirecting an emotional reaction from the rightful recipient to another “safer” target

Question 12

Identification with the Aggressor

Answer 12

Taking the role of the aggressor and modeling their attributes, feelings of admiration, gratitude, or identification

Child getting a shot
Stockholm Syndrome

Question 13

Which part of the brain controls circadian Rhythm?

Answer 13

Suprachiasmatic Nucleus (SCN) Hypothalamic area

Question 14

Which part of the brain produces melatonin?

Answer 14

Pineal Gland

Question 15

What is the role of Cortisol in sleep?

Answer 15

Decreases in the first phase of sleep, increases in the early hrs of the morning for wakefulness

Question 16

Explain the Reticular Activating System’s role in sleep

What is its neurotransmitter

Lesion?

Answer 16

Connects the brain stem to the thalamus to control arousal and alertness

NE

Damage will cause permanent coma

Question 17

Explain the Raphe Nucleus Role in Sleep

Neurotransmitter

Lesion?

Answer 17

Serotonergic neurons that go through the limbic system and forebrain to start sleep onset

Serotonin

Damage makes it so you can’t fall asleep

Question 18

Adenosine’s role in sleep?

Answer 18

Increase release w/ activity, it triggers sleep initiation

Question 19

Caffeine and sleep?

Answer 19

Antagonist of adenosine, makes it hard to get to sleep

Question 20

Acetylcholine and sleep?

Answer 20

NT for arousal.

Neurons in the dorsal pons and basal forebrain

Important for REM sleep

Question 21

NE and sleep?

Answer 21

Locus Coeruleus

Produce arousal and sleeplessness

Question 22

Serotonin and sleep?

Answer 22

Raphe Nuclei

Role is in activating behavior

Question 23

Histamine and sleep?

Answer 23

Hypothalamic Tuberomammillary Nucleus

Promote and stabilize wakefulness and attention

Question 24

Orexin and sleep?

Answer 24

Hypothalamus

Involved in wakefulness and arousal

Important in Narcolepsy

Question 25

Insomnia Tx?

Answer 25

Unsatisfying sleep quality or quantity w/ 1 or more of the following: Problem with sleep initiation Problem with sleep maintenance Awake 30 minutes before 6.5 hours of sleep Functional distress 3 nights/wk for 3 months Standard is non-pharm treatment. Sleep hygiene and therapy Z-drugs are the 1st line for insomnia

Question 26

What is the most common of the OTC sleep drug?

Answer 26

Diphenhydramine

Question 27

Obstructive Sleep Apnea Tx

Answer 27

Risks: Age over 40, obesity, male Leads to secondary insomnia Avoid use of sedatives Tx: CPAP/BIPAP

Question 28

Central Sleep Apnea Tx

Answer 28

Neurologic Abnormal breathing, awakening, not as much snoring as OSA Tx: Reduce Opioids, CPAP

Question 29

What is Somnambulism Tx

Answer 29

Sleep walking in non-REM sleep Tx: Z-drugs NOT recommended increases sleep driving/walking

Question 30

Nightmare Disorder DSM-5 Tx:

Answer 30

Recurrent well-remembered dreams Tx: Image Rehearsal Therapy, CBT Pharm: Prazosin

Question 31

REM Behavioral Disorder Tx

Answer 31

Modify sleep environment to decrease sleep injury Melatonin

Question 32

Sleep Terrors

Answer 32

Seen in age 3-7, but subside by 10 Dreams in non-REM No specific Tx

Question 33

Sleep Paralysis Tx

Answer 33

Hypnapompic Hallucinations Trouble getting out of REM sleep Tx: Pt education, Count down from 20

Question 34

What are the presumed purposes of sleep?

Answer 34

Conserve Energy Avoid Predation Sleeping for restoration Sleeping for memory

Question 35

Who wrote about alcohol to demonize it around the time of the revolution?

Answer 35

Benjamin Rush

Question 36

When was the 18th amendment enforced?

Answer 36

1920-1933

Question 37

How many Americans abstain from alcohol?

Answer 37

30% The 10% top drinkers drink more than half of the total alcohol in the US

Question 38

Who many people have alcohol use disorder and how many people get treatment?

Answer 38

14.4 million 18+ had the disorder. 7.9% got treatment 401,00 ages 12-17 had AUD. 5% got Tx

Question 39

What is the cause of Wernicke-Korsakoff syndrome

Answer 39

B-12, Thymine deficiency Causes Dementia and confabulation

Question 40

Explain the metabolism of alcohol

Answer 40

Steady rate of .25 oz/hr. LD50 is .40 BAC Presence of ETOH lowers metabolism of other drugs, and the absence of ETOH increases the metabolism of other drugs. Only in heavy drinkers.

Question 41

Prochaska and Diclemente (1983)

Answer 41

Trans theoretical Model of Change 6 stages, precontemplation, contemplation, prep, action, main, relapse

Question 42

Miller and Wilbourne (2003)

Answer 42

Mesa Grande- brief interventions, behavior, marital therapy | Pharmacology: Naltrexone

Question 43

What is alcohol withdrawal management

Answer 43

No caffeine, multivitamin, oral thiamine | For withdrawal delirium use Benzos

Question 44

What are medications you can use for alcohol use disorder?

Answer 44

Acamprosate: a-receptor blocker prevents relapse Disulfuram: Makes you sick to support your abstinence Oral Naltrexone: Tx for alcohol dependence Extended injectable Naltrexone

Question 45

Opioid Antagonists

Answer 45

Naloxone, nalorphine

Question 46

What are the symptoms of withdrawal symptoms How are they prevented?

Answer 46

``` Coma Pinpoint Pupils Respiratory Depression Hypotonia Hypothermia Hyporeflexia ``` Prevented with opioid agonist. Withdrawal precipitated sometimes when given naloxone, naltrexone, or buprenorphine

Question 47

What is the Tx for opioid withdrawal?

Answer 47

1. Gradual towering doses of opioid agonists - methadone (agonist) or buprenorphine (partial agonist) 2. Use of a2-adrenergic agonists like clonidine DON’T use anesthesia-assisted Withdrawal Management Psych Treatment Contingency Management: Rewards for positive reinforcement for abstinence CBT

Question 48

What are opioid overdose Tx: Explain the contraindications of the medications

Answer 48

Detox or Maintenance Methadone or Buprenorphine Methadone: Bugjuice -used to treat heroin addiction Contraindications: respiratory depression, increased QT, decreased parastatals Buprenorphine: mu-partial agonist Contraindications: hepatitis, current alcohol use, hypovolemia may cause OHTN, and syncope.