Introduction to the Competency-Based Assessment Model

Question 1

DSM-5 definition of mental illness?

Answer 1

A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above.

Question 2

What is Competency-Based Assessment Model?

Answer 2

framework for practice that focuses on client strengths, resilience and coping abilities, and identifying social environmental supports supported by…
Biospychosocial framework
Ecological perspective
Strengths perspective
Systems theory

Question 3

Neurons are composed of:

Answer 3

dendrites, soma, axon, myelin sheath, synapses

Question 4

Messages are transmitted across neurons in the brain via?

Answer 4

the synaptic cleft, and synaptic vesicles

Question 5

Better understood neurotransmitters are?

Answer 5

acetylcholine, glutamate, dopamine, serotonin, GABA

Question 6

The limbic system is the part of the brain involved in?

Answer 6

emotions, motivation, memory, and learning.

Question 7

Limbic system is comprised of:

Answer 7

Thalamus, Cerebral cortex, Hypothalamus, Hippocampus, Amygdala, Cingulate cortex

Question 8

The practitioner explores the nature of the client’s presenting problem looking to?

Answer 8

Reason for referral
Events leading up to the referral or other factors
Contributing conditions and problem components”
History, Duration, Frequency, Magnitude, Antecedents,
Consequences
And clarifies the client’s competencies

Question 9

The practitioner also explores the client’s current life situation looking to:

Answer 9

1. Intrapersonal (or personal) issues:
   Cognitive functioning, Emotional functioning
   Behavioral functioning, Physiologic functioning,
   Mental status, Client roles, and role performance
   Developmental considerations
2. Interpersonal family issues: marital/partner status and
   Family structure
3. Interpersonal work and/or school issues
4. Interpersonal issues with peers

Question 10

Client’s context and social support networks are explored through?

Answer 10

1.Environmental characteristics:
Environmental resources
Potential supports
Risks and vulnerabilities
Obstacles
Goodness of “fit” between client and the environment
2. Ethnic/cultural considerations:
Cultural group
Acculturation
Prejudice or discrimination
Economic injustice

Question 11

Central nervous system includes:

Answer 11

brain and spinal cord and received, processes, interprets and stores information and sends information to the muscles, glands and organs.

Question 12

Accetylchlorine (ACh)

Answer 12

neurotransmitter, was the first neurotransmitter to be discovered. It was isolated in 1921 by a German biologist named Otto Loewi, who would later win the Nobel Prize for his work. Acetylcholine has many functions: It is responsible for much of the stimulation of muscles, including the muscles of the gastro-intestinal system. It is also found in sensory neurons and in the autonomic nervous system, and has a part in scheduling REM (dream) sleep.

Question 13

Glutamate

Answer 13

major excitatory neurotransmitter. Plays a role in memory. Excess can result in overactivation and neuronal damage and cell death associated with stroke or head injury Alzheimer’s and Huntington’s disease.

Question 14

Dopamine (DA)

Answer 14

Another relative of norepinephrine and epinephrine is dopamine, discovered to be a neurotransmitter in the 1950s by another Swede, Arvid Carlsson. It is an inhibitory neurotransmitter, meaning that when it finds its way to its receptor sites, it blocks the tendency of that neuron to fire.
Dopamine is strongly associated with reward mechanisms in the brain. Drugs like cocaine, opium, heroin, and alcohol increase the levels of dopamine, as does nicotine!

Question 15

Serotonin (5-HT)

Answer 15

Serotonin is an inhibitory neurotransmitter that has been found to be intimately involved in emotion and mood. Too little serotonin has been shown to lead to depression, problems with anger control, obsessive-compulsive disorder, and suicide. Too little also leads to an increased appetite for carbohydrates (starchy foods) and trouble sleeping, which are also associated with depression and other emotional disorders. It has also been tied to migraines, irritable bowel syndrome, and fibromyalgia.

Question 16

Gaba acid

Answer 16

In 1950, Eugene Roberts and J. Awapara discovered GABA (gamma aminobutyric acid), which is also usually an inhibitory neurotransmitter. GABA acts like a brake to the excitatory neurotransmitters that lead to anxiety.
People with too little GABA tend to suffer from anxiety disorders, and drugs like Valium work by enhancing the effects of GABA. Lots of other drugs influence GABA receptors, including alcohol and barbituates. If GABA is lacking in some parts of the brain, epilepsy results.

Question 17

Brief Mini Mental Exam

Answer 17

ambulatory clinic for situational or personality problem and none of the CME criteria apply; appearance, motor, behavioral, quality of speech, affect and and mood are assessed. Consciousness, orientation, attention, memory, competence are inferred from the process, abnormal thoughts not typical unless other clinical clues, slepe appetite, libido energy levels and insights are always assessed

Question 18

Comprehensive Mental Exam

Answer 18

seen in ER, Crisis Clinic, nonpsychiatric ward for referral or psych admit, over 40; history of psych disorder, substance misuse, organic brain tissue deterioration or grasp has deteriorated. ; physical exam suggests brain dysfunction, forensic legal proceedings

Question 19

Provisional Diagnosis

Answer 19

Not enough data to support formal diagnosis; generally used when a diagnosis is time dependent such as schizophrenia and other psychotic disorders

Question 20

Other conditions that may need a clinical focus

Answer 20

Formally called “v” codes; may not be seen as mental disorders per se, but relavent to treatment or testing.

Question 21

Subtypes

Answer 21

they further distinguish differences within a particular disorder. Specify if other known medical, genetic or environmental factors,

Question 22

Neurotransmitters

Answer 22

are the chemicals which account for the transmission of signals from one neuron to the next across synapses. They are also found at the axon endings of motor neurons, where they stimulate the muscle fibers to contract. And they and their close relatives are produced by some glands such as the pituitary and the adrenal glands. In this chapter, we will review some of the most significant neurotransmitters.

Question 23

Norepinephrine

Answer 23

In 1946, a Swedish biologist by the name of Ulf von Euler discovered norepinephrine (formerly called noradrenalin). He also won a Nobel Prize. Norepinephrine is strongly associated with bringing our nervous systems into “high alert.” It is prevalent in the sympathetic nervous system, and it increases our heart rate and our blood pressure. Our adrenal glands release it into the blood stream, along with its close relative epinephrine (aka adrenalin). It is also important for forming memories.

Question 24

Categories of Neurons

Answer 24

Sensory neurons are sensitive to various non-neural stimuli. There are sensory neurons in the skin, muscles, joints, and organs that indicate pressure, temperature, and pain. There are more specialized neurons in the nose and tongue that are sensitive to the molecular shapes we perceive as tastes and smells. Neurons in the inner ear provide us with information about sound. And the rods and cones of the retina allow us to see.2. Motor neurons are able to stimulate muscle cells throughout the body, including the muscles of the heart, diaphragm, intestines, bladder, and glands.3. Interneurons are the neurons that provide connections between sensory and motor neurons, as well as between themselves. The neurons of the central nervous system, including the brain, are all interneurons.

Question 25

Glutamate

Answer 25

Glutamate is an excitatory relative of GABA. It is the most common neurotransmitter in the central nervous system – as much as half of all neurons in the brain – and is especially important in regards to memory. Curiously, glutamate is actually toxic to neurons, and an excess will kill them. Sometimes brain damage or a stroke will lead to an excess and end with many more brain cells dying than from the original trauma. ALS, more commonly known as Lou Gehrig’s disease, results from excessive glutamate production. Many believe it may also be responsible for quite a variety of diseases of the nervous system, and are looking for ways to minimize its effects
Glutamate was discovered by Kikunae Ikeda of Tokay Imperial Univ. in 1907, while looking for the flavor common to things like cheese, meat, and mushrooms. He was able to extract an acid from seaweed- glutamate. He went on to invent the well known seasoning MSG - monosodium glutamate. It took decades for Peter Usherwood to identify glutamate as a nurotransmitter in locusts in 1994.

Question 26

Endorphin

Answer 26

In 1973, Solomon Snyder and Candace Pert of Johns Hopkins discovered endorphin. Endorphin is short for “endogenous morphine,” i.e. built-in heroin! It is structurally very similar to the opioids (opium, morphine, heroin, etc.) and has similar functions: Inhibitory, it is involved in pain reduction and pleasure, and the opioid drugs work by attaching to endorphin’s receptor sites.
It is also the neurotransmitter that allows bears and other animals to hibernate. Consider: Heroin slows heart-rate, respiration, and metabolism in general – exactly what you would need to hibernate. Of course, sometimes heroin slows it all down to nothing: Permanent hibernation.

Question 27

Amygdala

Answer 27

This is a structure in the forebrain. It is part of the limbic system and plays a major role in emotional memory and the response to threat.

Question 28

Action Potential

Answer 28

This is an electrical charge that travels down the axon of a neuron to the synaptic terminal where it can increase or decrease the probability that hundreds of intracellular vesicles filled with neurotransmitter will fuse with the pre-synaptic membrane of that neuron and release the neurotransmitter into the synaptic cleft. The action potential occurs when the neuron has been activated and temporarily reverses the electric polarity of the interior membrane from negative to positive.

Question 29

Cerebellum

Answer 29

This is a large cauliflower-looking structure on the top of the brainstem. This structure is very important in motor movement and motor-vestibular memory and learning.

Question 30

Cerebral Cortex

Answer 30

This is the outer most layer of the cerebral hemisphere of the brain. The cortex mediates all conscious activity including planning, problem solving, language and speech. It is also involved in perception and voluntary motor activity.

Question 31

Hippocampus

Answer 31

This is a thin structure in the sub-cortex shaped like a seahorse. It is an important part of the limbic systems and plays a major role in learning, memory and emotional regulation.

Question 32

Hypothalamus

Answer 32

This is a group of important nuclei that mediate many important functions. It is located at the base of the brain and connected to the pituitary by a network of specialized blood vessels. The hypothalamic nuclei are involved in regulating many of the body’s internal organs via hormonal communication. The hypothalamus is a key part of the hypothalamic-pituitary-adrenal (HPA) axis that is so important in the stress response.

Question 33

Limbic system

Answer 33

This is a group of functionally and developmentally linked structures in the brain (including the amygdala, cingulate cortex, hippocampus, septum and basal ganglia). The limbic system is involved in regulation of emotion, memory and processing complex socio-emotional communication.

Question 34

Thalamus

Answer 34

This is a paired structure of two tiny egg-shaped structures in the diencephalon. This structure is a crucial area for integrating and organizing sensory information that comes into the brain. In the thalamus, this information is processed and forwarded to the key cortical areas where more processing and integrating will take place.