Intro Flashcards

1
Q

Define the biopsychosocial model

A

Bio, psycho & social factors that merge together forming a trifecta of importance to a patient’s perceptions, beliefs, relationships, and social situations.

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2
Q

3 overlapping factors of biopsychosocial model

A
  1. Bio-Medical (Risk factors): physical, genetic, biomechanical
  2. Psycho: Mental status, emotions, personality, behavior
  3. Social: Culture, socioeconomics, family, ethics, values
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3
Q

What is the difference between a counselor and a therapist

A
  • counselors give advise
  • therapist help the patient come up with solutions
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4
Q

Education for MFT?

A

grad degree + internship

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5
Q

Licensed alcohol & drug abuse counselor: training

A

master’s degree + 2 years field work

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6
Q

Substance Abuse Counselor: education

A

bachelors in social science

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7
Q

Social work: credentialing

A

LCSW (MSW, DSW, PhD)

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8
Q

Psychiatris: education

A

DO or MD

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9
Q

Psychologist: education

A

PhD, PsyD, EdD

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10
Q

Examples of social influence on Behavior

A
  1. Socioeconomic Factor
  2. Work environment
  3. Family relationships and social support
  4. Access to care (some can’t wait 2 mo. for appt)
  5. Personnel Resources
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11
Q

Behaviors influenced by psychosocial factors

A
  1. Stress Management
  2. Risk factor management / lifestyle change
  3. Compliance with treatment
  4. Treatment response
  5. Help seeking or help rejecting behaviors
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12
Q

What is the purpose of the DSM-5?

A
  1. Communication between clinicians
  2. Predict outcome of disorders
  3. Monitor treatment
  4. Litigation
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13
Q

Define mental disorder

A

A syndrome characterized by a significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes that regulate mental function. Usually these are associated w/ a significant distress or disability in social, occupational or other important activities. The behavior deviancy must be unexpected to one’s culture and social deviance is not necessarily a MD unless if results from the individual.

(TQ!!!)

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14
Q

Psychiatric illness: what info supports diagnosis?

A
  1. Symptoms
  2. Genetics
  3. Course of illness (onset, cycling)
  4. Response to tx

(meds are non-specific and may work on healthy pts, that doesn’t mean that they need it.)

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15
Q

Psych Exam: Differences from H & P

A
  1. Focus on psychiatric symptoms
  2. Focus on psychiatric and developmental history
  3. Mental status exam fully described
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16
Q

What are the identifying information in an evaluation?

A
  1. age/sex/race
  2. setting
  3. reason
  4. consent
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17
Q

HPI: what questions should you ask about sleep?

A
  • increased/decreased
  • restorative/nonrestorative
  • initial/terminal insomnia
  • periods of decreased sleep needs
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18
Q

HPI: questions about apetite (2)

A
  1. increased/decreaased
  2. weight gain/loss
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19
Q

HPI: questions to ask about concentration?

A
  1. impairment
  2. racing thoughts
  3. distracted
  4. difficulty in decision making
20
Q

HPI: questions to ask about memory?

A

deficits in long or short term

21
Q

HPI: questions to ask about energy?

A
  1. fatigue
  2. hyper
22
Q

HPI: questions to ask about interest/motivation?

A

have gained or lost interest in hobbies

23
Q

HPI: questions to ask about suicidal ideation (5)

A
  1. thoughts
  2. plans
  3. intent
  4. means
  5. self-control or urges
24
Q

HPI: questions to ask about homicidal ideation (7)

A
  1. target
  2. thoughts
  3. intent
  4. plans
  5. means
  6. control
  7. urges
25
Q

HPI: thoughts to ask about hallucinations (8)?

A
  1. auditory
  2. visual
  3. tactile
  4. olfactory
  5. nature
  6. frequency
  7. reality testing
  8. command hallucinations
26
Q

HPI: delution types

A
  1. grandiose
  2. paranoid
  3. erotomanic
  4. bizarre
27
Q

HPI: self-destructive behaviors (5)

A
  1. self-cutting
  2. self-induced emesis
  3. binging
  4. skin-picking
  5. hair-pulling
28
Q

HPI: anger problems

A
  1. verbal or physical
  2. duration
29
Q

HPI: reckless behavior

A
  1. overspending
  2. promiscuity (libido)
  3. substance use
30
Q

HPI: questions to ask about mood

A
  1. depression
  2. anxiety
  3. mood swings
31
Q

HPI: questions to ask about pain (2)

A
  1. does it interfere w/their life
  2. what would life be like if you didn’t have pain
32
Q

HPI: questions to ask about life circumstances (3)

A
  1. guilt
  2. stressors
  3. self-confidence/self-esteem
33
Q

HPI: for all symptoms that are positive you should also assess _____ (6).

A
  1. severity
  2. duration
  3. importance to pts well-being
  4. degree of disabiltiy
  5. palliative
  6. provocative
34
Q

Past psych Hx (PPH) (4)

A
  1. past hospitalizations
  2. past suicides
  3. past psychotherapy trials and response
  4. past medications (therapy and side effects)
35
Q

HPI: questions to ask about substance use (8)

A
  1. 1st use age
  2. periods of abstinence
  3. Illicit drugs that are not associated in a tox screen
  4. amounts and frequency
  5. blackouts - associated w/abnormal use
  6. Siezures
  7. Withdrawl
  8. Legal problems
36
Q

HPI: past medical Hx (3)

A
  1. OLDCARTS
  2. Hx of head injury
  3. Allergies
37
Q

Lab tests for psych eval

A
  1. Brain imaging
  2. EEG
  3. Sleep study
  4. MD labs: CMP, CBC, TSH, Lipid panel, B12, folate (B9)
38
Q

Fam Hx for psych eval

A
  1. marital status
  2. children
  3. family w/conditions
  4. who do they live with
39
Q

What questions should you ask about the patient’s family of origin?

A
  1. parents: marital status & occupation
  2. siblings
  3. family hx of pscy illness
  4. Hx of abuse
40
Q

Social Hx questions

A
  1. Occupation: how long, satisfaction, dream as a tenn
  2. Education: how far, academic prowess, problems at school (hyper, trouble, distractibility)
  3. Military
  4. Legal
  5. Rec activities
  6. Support system
41
Q

Military Hx questions

A
  1. exposure to combat
  2. type of discharge
  3. rank at discharge
42
Q

Pros & cons to DSM5

A
  • Pros: improves reliabiltiy of dx, clarifies dx process & hx taking
  • Cons: increases dx precisions may give false certainty, may sacrifice validity for reliability, depersonalize the dx process
43
Q

When does a patient meet inpatient criteria?

A
  1. danger to self or others
  2. unable to care for self
  3. medical detox
  4. failure to improve in outpatient

(Usually the most popular in rural centers due to lack of psychiatrists and specialists of any type in the areas)

44
Q

Partial Hospital Program Criteria

A

Need for intensive Tx w/o dangerousness

(Typically meets for 6 hours a day/ 5x a week)

45
Q

Intensive Outpatient Program Criteria

A
  1. Able to care for self
  2. Stable levels of dangerousness
  3. Need for active support

(Typically meets 3 hours a day/ 3-5x a week)

46
Q

Outpatient psychiatric care (30

A
  1. Most common type of Tx
  2. Typically meets 1/week
  3. Periodic medical management to maintain patient stability.