PSYCH EXAM 2 Flashcards
(125 cards)
1
Q
“the state manifested by a specific syndrome which consists of all the nonspecifically induced changes within a biological system
A
stress
2
Q
what selye called the general reaction of the body to stress
A
general adaptation syndrome
3
Q
a stimulus arising from the internal or external environment and is perceived by the individual in a specific manner
A
precipitating event
4
Q
a variety of elements that influence how an individual perceives and responds to a stressful event
A
predisposing factors
5
Q
3 types of predisposing factors
A
- genetic influences
- past experiences
- existing conditions
6
Q
are those circumstances of an individual’s life that are acquired through heredity.
A
genetic influence
7
Q
examples of genetic influence
A
family history of physical and psychological conditions
&
temperment
8
Q
are occurrences that result in learned patterns that can influence an individual’s adaptation response. They include previous exposure to the stressor or other stressors, learned coping responses, and degree of adaptation to previous stressors.
A
past experiences
9
Q
incorporate vulnerabilities that influence the adequacy of the individual’s physical, psychological, and social resources for dealing with adaptive demands
A
existing conditions
10
Q
ex of existing conditions
A
current health status motivation developmental maturity severity and duration of the stressor financial and educational resources age existing coping strategies support system
11
Q
the initial step in managing stress.
A
awareness
12
Q
to become aware of the factors that create the stress and the feelings associated with a stressful response.
A
awareness
13
Q
can only be controlled when one recognizes that it is being experienced.
A
stress
14
Q
engaging in large motor activities, such as sports, jogging, and physical exercise. Breathing exercises and progressive relaxation to relieve stress.
A
relaxation
15
Q
involves assuming a comfortable position, closing the eyes, casting off all other thoughts, and concentrating on a single word, sound, or phrase that has positive meaning to the individual
A
meditation
16
Q
sometimes just “talking the problem out” with an individual who is empathetic is sufficient to interrupt escalation of the stress response
A
interpersonal communication with caring other
17
Q
an extremely adaptive coping strategy is to view the situation objectively (or to seek assistance from another individual to accomplish this if the anxiety level is too high to concentrate)
A
problem solving
18
Q
studies show that those who care for ___, are better able to cope with the stressors of life
A
pets
19
Q
can reduce depression and bring about measurable changes in mood and general activity.
stimulates motivation, enjoyment, and relaxation
A
music
20
Q
4 levels of anxiety
A
mild moderate severe panic
21
Q
this level of anxiety is seldom a problem for the individual. It is associated with the tension experienced in response to the events of day-to-day living.
prepares people for action
sharpens the senses, increases motivation for productivity
increases the perceptual field, and results in a heightened awareness of the environment.
learning is enhanced and the individual is able to function at his/her optimal level
A
mild anxiety
22
Q
as the level of anxiety increases, the extent of the perceptual field _____.
A
diminishes
23
Q
is less alert to events occurring in the environment
attention span and ability to concentrate decreases, although he/she may still attend to needs with direction.
assistance with problem solving may be required
increased muscular tension and restlessness are evident.
A
moderate anxiety
24
Q
the perceptual field is so greatly diminished that concentration centers on one particular detail only or on many extraneous details.
attention span is extremely limited, and the individual has much difficulty completing event the simplest task.
physical and emotional symptoms may be evident.
discomfort is experienced to the degree that virtually all overt behavior is aimed at relieving the anxiety
A
severe anxiety
25
in this most intense state of anxiety, the individual is unable to focus on even one detail in the environment.
misperceptions are common, and a loss of contact with reality may occur.
hallucinations and delusions
behavior is characterized by wild and desperate actions or extreme withdrawal
panic anxiety
26
ways to treat mild anxiety
sleeping, yawning, eating, drinking, physical exercise, daydreaming, smoking, laughing, crying, cursing, pacing, nail biting, foot swinging, finger tapping, fidgeting, & talking with someone whom one feels comfortable
27
use defense mechanisms
mild to moderate anxiety
28
covering up a real or perceived weakness by emphasizing a trait one considers more desireable
compensation
29
refusing to acknowledge the existence of a real situation or the feelings associated with it
denial
30
the transfer of feelings from one target to another that is considered less threatening or that is neutral
displacement
31
an attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual processes of logic, reasoning, and analysis.
intellectualization
32
integrating the beliefs and values of another individual into one's own ego structure
introjection
33
separating a thought or memory from the feeling, tone, or emotion associated with it.
isolation
34
attributing feelings or impulses unacceptable to one's self to another person
projection
35
attempting to make excuses or formulate logical reasons to justify unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors
reaction formation
36
retreating in response to stress to an earlier level of development and the comfort measures associated with that level of functioning
regression
37
involuntarily blocking unpleasant feelings and experiences from one's awareness
repression
38
rechanneling of drives or impulses that are personally or social unacceptable into activities that are constructive.
sublimation
39
the voluntary blocking of unpleasant feelings and experiences from one's awareness
suppression
40
symbolically negating or canceling out an experience that one finds intolerable.
undoing
41
if this level of anxiety remains unresolved over an extended period of time can contribute to a number of physiological disorders.
moderate to severe anxiety
42
can lead to neurosis if untreated
severe anxiety
43
psychiatric disturbances, characterized by excessive anxiety that is expressed directly or altered through defense mechanisms.
neuroses
44
at this extreme level of anxiety, an individual is not capable of processing what is happening in the environment, and may lose contact with reality.
panic anxiety
45
"a severe mental disorder characterized by gross impairment in reality testing, typically manifested by delusions, hallucinations, disorganized speech, or disorganized or catatonic behavior."
psychosis
46
an external pressure that is brought to bear on the individual.
stressor
47
involves the threatening stimulus; anxiety involves the emotional response to the appraisal.
fear
48
the major inhibitory neurotransmitter in the brain.
GABA
49
involved in the reduction and slowing of cellular activity.
GABA
50
increases the affinity of the GABAa receptor for GABA
benzodiazepines
51
short term, quick, PRN use
benzodiazepines
52
block repuptake of serotonin into the presynaptic nerve terminal, increasing synaptic concentration of serotonin
SSRIs
53
long term use
SSRIs
54
for chronic anxiety. Long term
buspirone
55
is characterized by recurrent panic attacks, the onset of which is unpredictable
panic disorder
56
panic disorder manifestations
intense apprehension
| fear or terror, often associated with feelings of impending doom and accompanied by intense physical discomfort
57
this defines the fear that some patients have of being in open shops and markets, although "their true feat is being separated from a source of security."
agoraphobia
58
is an excessive fear of situations in which a person might do something emberassing or be evaluated negatively by others.
social anxiety disorder
59
identified by fear of specific objects or situations that could conceivably cause harm, but the person's reaction to them is excessive, unreasonable, and inappropriate.
are often identified when other anxiety disorders have become a focus of clinical attention.
specific phobia.
60
Freud believed that phobias developed when a child experiences normal incestuous feelings toward the opposite gender parent. To protect themselves, these children repress this fear of hostility from the same-gender parent and displace it onto something safer and more neutral, which becomes the phobic stimulus.
Freud's Psychoanalytic theory
61
the manifestations of this disorder include the presence of obsessions, compulsions, or both, the severity of which is significant enough to cause distress or impairment in social, occupational, or other important areas of functioning.
they recognize that the behavior is excessive or unreasonable, but because of the feeling of relief from discomfort that it promotes, is compelled to continue the act
Obessive-compulsive disorder
62
is characterized by the exaggerated belief that the body is deformed or defective in some specific way.
body dysmorphic disorder
63
the recurrent pulling out of one's hair that results in hair loss
trichotillomania
64
"persistent difficulties discarding or parting with possessions, regardless of their actual value."
hoarding disorder
65
are characterized by physical symptoms suggesting medical disease but without demonstrable organic pathology or a known pathophysiological mechanism to account for them.
Somatic symptom disorders
66
are defined by a disruption in the usually integrated functions of consciousness, memory, and identity.
Dissociative disorders
67
(when crazy news doesn’t seem real and the situation doesn’t seem real)
Dissociative disorders
68
Freud viewed dissociation as a type of _______, an active defense mechanisms used to remove threatening or unacceptable mental contents from conscious awareness.
repression
69
Somatic symptom disorders have been identified as hysterical neuroses and were thought to occur in response to _____.
repressed severe anxiety
70
A syndrome of multiple somatic symptoms that can’t be explained medically and are associated with psychosocial distress and long-term seeking of assistance from health care professionals.
The disorder is chronic
Drug abuse and dependence are common complications
Personality characteristics are heightened emotionality, strong dependency needs, and a preoccupation with symptoms and oneself.
Somatic symptom disorder
71
Unrealistic or inaccurate interpretation of physical symptoms or sensations leading to preoccupation and fear of having a serious disease.
Their behavioral response to even the slightest changes in feeling or sensation is unrealistic and exaggerated.
Anxiety and depression are common, and obsessive-compulsive traits frequently accompany the disorder
Illness Anxiety Disorder
72
A loss or change in body function that cannot be explained by any known medical disorder or pathophysiological mechanism.
conversion disorder
73
blindness after seeing something stressful
paralysis of legs in response of fear to "walk down the isle"
conversion disorder
74
The most obvious and “classic” conversion symptoms are those that suggest ___ ____.
neurological disease
75
With this diagnosis, there is evidence of a general medical condition that has been precipitated by or is being perpetuated by psychological or behavioral circumstances.
psychological factors affecting other medical conditions
76
Conscious, intentional feigning of physical and/or psychological symptoms
individual pretends to be ill in order to receive emotional care and support commonly associated with the role of “patient.”
Factitious Disorder
77
factitious disorder AKA
Munchausen syndrome
78
predisposing factors associated with somatic symptom disorder
```
genetic
biochemical
neuroanatomical
psychodynamic theory
family dynamics
learning theory
```
79
in dysfunctional families, when a child becomes ill, focus shifts from the open conflict to the child’s illness and leaves unresolved underlying issues the family is unable to confront openly. Somatization brings some stability to the family and positive reinforcement to the child (called tertiary gain).
family dynamics
80
primary
secondary
tertiary gain
learning theory
81
may avoid stressful obligations or be excused from unwanted duties
primary gain
82
may become the prominent focus of attention because of the illness
secondary gain
83
may relieve conflict within the family as concern is shifted to the ill person and away from the real issue
tertiary gain
84
past experiences with serious or life-threatening physical illness, either personal or that of close relatives, can predispose the person to this disorder
illness anxiety disorder
85
defined as an inability to recall important personal info that is too extensive to be explained by ordinary forgetfulness and which is not due to the direct effects of substance use or a neurological or other medical condition. Onset usually follows severe psychosocial stress.
dissociative amnesia
86
inability to recall all incidents associated with the traumatic event for a specific period following the event
localized amnesia
87
inability to recall only certain incidents associated with a traumatic event for a specific period following the event.
selective amnesia
88
the individual has amnesia for his or her identity and total life history
generalized amnesia
89
A specific subtype of dissociative amnesia in which there is sudden, unexpected travel away from home with the inability to recall some or all of one’s past.
dissociative fugue
90
Characterized by the existence of two or more personalities within a single individual
sudden & precipitated by stress.
Dissociative identity disorder (DID)
91
is defined as a disturbance in the perception of oneself
depersonalization
92
described as an alternation in the perception of the external environment.
derealization
93
Characterized by a temporary change in the quality of self-awareness that often takes the form of: feelings of unreality, changes in body image, feelings of detachment from the environment, & a sense of observing oneself from outside the body.
Depersonalization-derealization disorder
94
symptoms of Depersonalization-derealization disorder are accompanied by:
anxiety & depression
fear of going insane
obsessive thoughts
95
predisposing factors to dissociative disorders
genetics
neurobioligical
psychodynamic theory
psychological trauma
96
possible heredity factors associated with DID
genetics
97
dissociative amnesia may be related to neurophysiological dysfunction.
EEG abnormalities have been observed in some clients withDID.
neurobiological
98
freud described dissociation as repression of distressing mental contents from conscious awareness. Current psychodynamic explanations reflect Freud’s concepts.
Psychodynamic theory
99
a growing body of evidence points to the etiology of DID as a set of traumatic experiences that overwhelm the individuals capacity to cope by any means other than dissociation.
these experiences usually take the form of severe physical, sexual, or psychological abuse by a significant other in the child’s life.
DID is thought to be a survival method.
psychological trauma
100
similar to PTSD in terms of precipitating traumatic events and symptomatology.
symptoms are time limited--up to 1 month following the trauma
Acute Stress Disorder
| ASD
101
if ASD lasts longer than 1 month it is considered...
PTSD
102
a reaction to an extreme trauma, which is likely to cause pervasive distress to almost anyone, such as natural or manmade disasters, combat, serious accidents, witnessing the violent death of others, being the victim of torture, terrorism, rape, or other crimes.
PTSD
103
characteristic symptoms of PTSD include
reexperiencing the traumatic event
a sustained high level of anxiety or arousal
a general numbing of responsiveness
intrusive recollections or nightmares
amnesia to certain aspects of the trauma
depression, survivors, guilt
substance abuse
anger and aggression
relationship problems
104
when may symptoms begin for PTSD
within the first 3 months after the trauma, or there may be a delay of several months or even years.
105
predisposing factors for trauma related disorders
psychosocial theory
learning theory
cognitive theory
106
dysregulation of the opiod, glutamatergic, noradrenergic, serotonergic, and neuroendocrine pathways may also be involved in the pathophysiology of PTSD
biological aspects
107
nursing dx for posttrauma syndrome
complicated grieving
108
outcome criteria....
the client:
can acknowledge the and the impact on his/her life
can demonstrate adaptive coping strategies
has worked through feelings of survivors guilt
attends support group of individuals recovering from similar traumatic experiences
109
nursing care of the client with a trauma related disorder is aimed at
reassurance of safety
decrease in maladaptive symptoms
demonstration of more adaptive coping strategies
adaptive progression through the grieving process
110
evaluation of care for the client with trauma-related disorder is based on
successful achievement of the previously established outcome criteria
111
examples of evaulation
can the client discuss the traumatic event without experiencing panic anxiety?
has the client learned new, adaptive coping strategies for assistance with recovery?
112
trauma related disorders
cognitive therapy
prolonged exposure therapy
group/family therapy
eye movement desensitization and reprocessing
psychopharmacology --client education
113
characterized by a maladaptive reaction to an identifiable stressor or stressors that results in the development of clinically significant emotional or behavioral symptoms
adjustment disorders
114
symptoms occur within 3 months of the stressor and last no longer than 6 months
adjustment disorders
115
types of adjustment disorders
with anxiety
with mixed anxiety and depressed mood
116
predisposing factors for adjustment disorders
biological theories
genetics
vulnerability related to neurocognitive or intellectual developmental disorders
psychosocial theories
transactional model of stress/adaptation
117
nursing dx of adjustment disorders
complicated grieving
risk--prone health behavior
anxiety
118
outcome criteria for adjustment disorders..
the client:
verbalizes acceptable grieving behaviors
accomplishes ADLs independently
demonstrates ability to function adequately
accepts change in health status
sets realistic goals for the future
demonstrates ability to cope effectively with change in lifestyle
119
nursing intervention for the client with an adjustment disorder is aimed at:
adaptive progression through the grief process
helping the client achieve acceptance of a change in health status
assisting with strategies to maintain anxiety at a manageable level
120
evaluation of pt with adjustment disorders is based on...
accomplishment of previously established outcome criteria
121
examples of adjustment disorder evaluations
does the client demonstrate progression in the grief process?
does the client discuss the change in health status and modification of lifestyle it will affect?
does the client set realistic goals for the future?
122
tx for adjustment disorders
individual psychotherapy
family therapy
behavior therapy
self-help therapy
crisis intervention
psychopharmacology
123
first like med of choice in the tx of ptsd
paroxetine
| SSRIs
124
are considered first-line tx of choice for PTSD because of their efficacy, tolerability, and safety ratings.
SSRIs
125
ex of SSRIs
paroxetine and sertraline
