Week 1 to 7 Flashcards
1
Q
What diagnosis is described below?
Two (or more) of the following, each present for a significant portion of time during a 1-month period
(or less if successfully treated). At least one of these must be (1), (2), or (3):
1. Delusions
2. Hallucinations
3. Disorganized speech (e.g., frequent derailment or incoherence)
4. Grossly disorganized or catatonic behavior
5. Negative symptoms (i.e., diminished emotional expression or avolition).
onset of the disturbance, level of functioning in one or more major areas of functioning, such as work, interpersonal relations, or self-care, is markedly below the level achieved before the onset
Continuous signs of the disturbance persist for at least 6 months (at least 1 month of symptoms)
disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition
A
DSM-5 Diagnostic Criteria for Schizophrenia
2
Q
What are the 5 subtypes of schizophrenia:
A
paranoid type disorganized type catatonic type Undifferentiated Type Residual Type
3
Q
What subtype of schizophrenia is described below?
characterized by preoccupation with one or more delusions or frequent auditory hallucinations
A
paranoid type
4
Q
What subtype of schizophrenia is described below?
characterized by a marked regression to primitive, disinhibited, and unorganized behavior and by the absence of symptoms that meet the criteria for the catatonic type
A
disorganized type
5
Q
What subtype of schizophrenia is described below?
is a marked disturbance in motor function; this disturbance may involve stupor, negativism, rigidity, excitement, or posturing. Sometimes the patient shows a rapid alteration between extremes of excitement and stupor.
A
catatonic type
6
Q
What subtype of schizophrenia is described below?
patients who clearly have schizophrenia cannot be easily fit into one type or another.
A
Undifferentiated Type
7
Q
What subtype of schizophrenia is described below?
Emotional blunting, social withdrawal, eccentric behavior, illogical thinking, and mild loosening of associations commonly appear in the residual type. When delusions or hallucinations occur, they are neither prominent nor accompanied by strong affect.
A
Residual Type
8
Q
What diagnosis is described below?
The main feature is
amnesia where the person had the inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by normal forgetfulness
A
Dissociative Amnesia
9
Q
Dissociation is usually caused by
A
trauma
10
Q
What type of amenisa is described below?
inability to recall events related to circumscribed period of time
A
Localized Amnesia
11
Q
What type of amenisa is described below?
ability to remember some but not all events related to a circumscribed period of time
A
Selective Amnesia
12
Q
What type of amenisa is described below?
failure to recall one’s entire life
A
Generalized Amnesia
13
Q
What type of amenisa is described below?
failure to remember successive events as they occur
A
Continuous Amnesia
14
Q
What type of amenisa is described below?
failure to remember a category of info (such as memories of family or just one person in particular)
A
Systematized Amnesia
15
Q
What type of amenisa is described below?
is a condition characterized by sudden onset of memory loss and confusion.
During an episode of TGA, a person is not able to make new memories. The person may be disoriented in regard to time and place, but can remember who they are and can recognize family members.
A
Transient Global Amnesia:
16
Q
Define fugue
A
purposeful movement from one place to another
17
Q
Malingering illness is when…
A
someone exaggerates an illness in order to get out of work, evite police, receive free room and board at a hospital, they usually have financial goals and symptoms usually disappear once it’s no longer profitable to them
18
Q
This food disorder is a syndrome characterized by these three essential criteria.
The first is a self induced starvation to a significant degree—a behavior.
The second is a relentless drive for thinness or a morbid
fear of fatness—a psychopathology.
The third criterion is the presence of medical signs and symptoms resulting from starvation—a physiological symptomatology
A
Anorexia nervosa
19
Q
What are the sub-types of Anorexia nervosa
A
restricting and binge/purge
20
Q
Which is described below (restricting or binge/purge) ?
During the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas).
This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise.
- attempts to consume fewer than 300 to 500 calories per day and no fat grams
- relentlessly and compulsively overactive, with overuse athletic injuries
A
Restricting type
21
Q
Which is described below (restricting or binge/purge) ?
During the last 3 months, the individual has engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or misuse of laxatives, diuretics, or enemas).
- Purging represents a secondary compensation for the unwanted calories, most often accomplished by self-induced vomiting, frequently by laxative abuse, less frequently by diuretics, and occasionally with emetics
- repetitive purging occurs without prior binge eating, after ingesting only relatively few calories
- Overexercising and perfectionistic traits are also common in both types
A
Binge-eating/purging type
22
Q
What eating disorder is described below?
-characterized by episodes of binge eating combined with inappropriate ways of stopping weight gain; typically maintain a normal body weight; Physical discomfort: terminates the binge eating, which is often followed by feelings of guilt, depression, or self-disgust.
A
Bulimia nervosa
23
Q
What eating disorder is described below?
engage in recurrent binge eating during which they eat an abnormally large amount of food over a short time. Unlike bulimia nervosa, patients with this disorder do not compensate in any way after a binge episode
A
- binge eating disorder
24
Q
What eating disorder is described below?
- characterized by the consumption of large amounts of food after the evening meal. Individuals generally have little appetite during the day and suffer from insomnia.
- common among patients with other eating disorders, particularly bulimia nervosa and binge eating disorder.
A
Night Eating Syndrome
25
What eating disorder is described below?
- characterized by recurrent purging behavior after consuming a small amount of food in persons of normal weight who have a distorted view of their weight or body image.
- Purging behavior includes self-induced vomiting, laxative abuse, enemas, and diuretics
- To make the diagnosis, the behavior must not be associated with anorexia nervosa.
Purging Disorder
26
What disorder is described below?
-represented by a diverse group of symptoms that include intrusive
thoughts, rituals, preoccupations, and compulsions.
- recurrent obsessions or compulsions cause severe distress to the person.
- obsessions or compulsions are time-consuming and interfere significantly with the person's normal routine, occupational functioning, usual social activities, or relationships.
Obsessive-compulsive disorder (OCD)
27
Define obsession
- a recurrent and intrusive thought, feeling, idea, or sensation.
- obsession is a mental event,
28
Define Compulsion
- is a conscious, standardized, -recurrent behavior, such as counting, checking, or avoiding.
- a compulsion is a behavior.
29
Substance-Induced Obsessive-Compulsive/related disorder
characterized by the emergence of obsessive-compulsive or related symptoms as a result of a substance, including drugs, medications, and alcohol.
30
Symptoms of Substance-Induced Obsessive-Compulsive/related disorder
present either during use or within a month after substance use, intoxication, or withdrawal.
31
Olfactory Reference Syndrome
characterized by a false belief by the patient that he or she has a foul body odor that is not perceived by others
-preoccupation leads to repetitive behaviors such as washing the body or
changing clothes.
-The patient may have good, fair, poor, or absent insight into the behavior.
-The syndrome is
predominant in males and single status.
32
Body dysmorphic disorder
characterized by a preoccupation with an imagined defect in appearance that
causes clinically significant distress or impairment in important areas of functioning.
33
Hoarding Disorder
acquiring and not discarding things that are deemed to be of little or no value, resulting in excessive clutter of living spaces.
34
Hair-Pulling Disorder (Trichotillomania)
chronic disorder characterized by repetitive hair pulling, leading to variable hair loss that
may be visible to others.
35
Excoriation (Skin-Picking) Disorder
characterized by the compulsive and repetitive picking of the skin.
36
Factitious dermatitis
a disorder in which skin-picking is the target of self-inflicted injury
and the patient uses more elaborate methods than simple excoriation to self-induce skin lesions.
37
What disorder is described below?
- Depressed mood most of the day, nearly every day (per subjective report)
- Markedly diminished interest or pleasure in all (or almost all) activities most of the day, nearly every day
- Significant weight loss when not dieting OR weight gain OR a decrease or increase in appetite nearly every day
- Insomnia or hypersomnia nearly every day
- Psychomotor agitation (observable by others)
-Fatigue or loss of energy
Feelings of worthlessness or inappropriate feelings of guilt
- Diminished ability to think or concentrate; indecisiveness
- Recurrent thoughts of death or recurrent suicidal ideation
Major Depressive Disorder:
major depressive episode must last at least 2 weeks
38
Define Manic episode:
a period where a person’s mood is abnormally and persistently elevated, expansive, or irritable that impedes functioning. Lasts at least 1 week or less.
39
Define Hypomanic episode
similar to mania but not as severe-- this episode does not impede social or occupational functioning & no psychotic features are present; lasts at least 4 consecutive days.
40
Bipolar 1 or Bipolar II?
- must experience a manic episode (at least 1 lifetime manic episode is required for the diagnosis of bipolar I disorder)
- manic episode is often preceded by hypomanic or major depressive episode
Bipolar I Disorder:
41
Bipolar 1 or Bipolar II?
episodes of major depression and hypomania
Bipolar II Disorder
42
What's a mixed episode?
period of at least 1 week in which both a manic episode & a major depressive episode occur almost daily
43
Dysthymic disorder?
At least 2 years of depressed mood that is not severe enough to be diagnosed as a major depressive disorder
44
Cyclothymic disorder?
2 years of frequently occurring hypomanic symptoms that cannot fit the diagnosis of manic episodes AND of depressive symptoms that cannot fit the diagnosis of major depressive disorder
*Basically… a less severe version of Bipolar II disorder
45
What are the 3 foci of OT practice?
1. Enabling engagement
2. Promoting health
3. Maximizing potential
46
Goal of Occupational Therapy in Psychosocial Practice
directed to creating conditions and contexts for
participation in occupations that enable successful and satisfying occupational
engagement and support psychological, emotional, and social health and well-being.
47
Intake: Building rapport
```
Active listening
Open body language
Nonverbal communication
Start small
Respect
Mirror/match
Therapeutic use of self
```
48
What's the 8 parts of the intake assessment?
```
Done as an interview with the following parts
Demographic data
Diagnosis (AXIS I-V, DSM - V)
Chief Complaint
Hx of present illness
Past medical hx
Mood/Behavior
Mental Status
Pt goals/discussion of treatment
```
49
Closed questions are...?
es/no responses or responses that only have one right answer
| What is your birthday? How old are you? What is your favorite color? = closed
50
Open ended questions allow ...
the therapist to gain insight into the client and allow the client to provide more detail
How does it make you feel? Why do you think that is? Describe your home to me = open
51
```
WWII
a period of:
- increasing demand of health professionals
-Crafts shifting to rehab
-ADL
-Ergonomic Assessment:modifications
-Vocational Rehab
- Prosthesis
```
Early Evolution of
Psychosocial
Occupational Therapy- what are the 4 era/movements?
Progressive Era: an era of significant social progress, including reforms in education and mental health
Mental Hygiene Movement:
concerned with the maintainance of mental stability; emphasized that therapeutic occupation needed to possess a certain dignity and hold meaning for the patient
Arts and Crafts Movement: Ruskin and Morris were the founders.
Believed that using one's hands to create things connected people to their work and contributed to physical and mental health.
Settlement House Movement: Important reform institutions mainly for immigrants; Clarke Believed engaging immigrants in every day occupations was curative. "Mother of OT".
52
Competing Paradigms in Psychosocial Practice- Biomedical
```
• Observable
phenomena
“reduced” to
measurable units
whose relationship
to each other can be
described
```
• Applied where
illnesses are acute
• Often applied in inpatient settings
where access to
natural occupations
is limited
53
Competing Paradigms in Psychosocial Practice- Rehabilitation
Approaches and
services that improve
community living,
citizenship
```
• Emphasis on
autonomy, self-determination,
decision making skill
and resource
development
```
• Services offered in
the community, and
in the person’s
natural context
54
Competing Paradigms in Psychosocial Practice- Recovery
```
Processes individuals
undergo in their
journey to health and
achievement of full
potential
```
• Development of
identity beyond that
of person with a
mental illness
• Services can be
oriented to
supporting recovery
55
Competing Paradigms in Psychosocial Practice- Empowerment
```
• Approaches oriented
to:
o perceived power, to
make choices in
one’s life
```
o actual power, to have
control over life
events
o establish positive
identity, participate
in valued social roles
o access to material
resources and
opportunities
56
Competing Paradigms in Psychosocial Practice- Population and Public
Health
Focus on populations
```
• Ill health, including
mental illness, can
emerge from
negative conditions
in key social
determinants of
health
```
```
• Occupational
engagement and
meaning are both
individual and social
constructs
```
57
What are 8 factors influencing psychosocial OT?
```
1. The focus on
occupation
2. Evidence-based
practice
3. Employment
and payment
structures
4. Spirituality
5. Trauma, violence,
war and disaster
6. Deepening
understandings of
discrimination and
stigma
7. Integrating diverse
and traditional
knowledge into
practice
8. Interprofessional
practice
```
58
What are the 4 most common pattern of obsession?
Contamination: fear of things such as feces, urine, dust, or germs
pathological doubt: implies danger/violence
intrusive thoughts: usually thoughts of repetitive sexual/aggressive acts
symmetry: obsession of symmetry/precision
59
Define psychotic features
categorized as either mood congruent (in harmony with the mood disorder) or mood incongruent (not in harmony with the mood disorder)
Ex. of mood congruent: “I feel horrible, therefore I deserve to be punished” -- the thoughts are congruent with how your body feels
Ex. of mood incongruent: “I feel horrible, but I don’t know why I feel this way because I’m the best at everything” --this is where you may want to consider schizophrenia/schizoaffective over a mood disorder
60
Define Melancholia
depression characterized by severe anhedonia (inability to feel pleasure) & profound feelings of guilt (often over trivial events)
**Sometimes referred to as “endogenous depression” or depression that arises in the absence of external life stressors
61
Define Atypical features of mood disorder
characteristics of overeating and oversleeping; atypical depression may mask manic symptoms
62
What are catatonic features:
hallmark symptoms-- stuporousness, blunted affect, extreme withdrawal, negativism, & marked psychomotor retardation
63
Postpartum depression:
onset of symptoms within 4 weeks postpartum
64
Rapid cycling
having at least 4 episodes within a 12-month period
65
What disorder is described below?
associated with significant morbidity and often are chronic and resistant to treatment.
include (1) panic disorder, (2) agoraphobia, (3) specific phobia, (4) social anxiety disorder or phobia, and (5) generalized anxiety disorder.
Anxiety and related disorders
66
What's normal anxiety?
commonly as a diffuse, unpleasant, vague sense of apprehension
-accompanied by autonomic symptoms such as headache, perspiration, palpitations, tightness in the chest, mild stomach discomfort, and restlessness, indicated by an inability to sit or stand still for long.
67
Fear vs anxiety
anxiety = alerting signal which warns of impending danger; response to a threat that is unknown, internal, vague, or conflictual.
Fear= is a response to known external, definite, or non conflictual threat
68
Define panic disorder and treatment
Panic Disorder: An acute intense attack of anxiety accompanied by feelings of impending doom
Treatment: Cognitive and behavior therapies are effective treatments for panic disorder. The information about panic attacks includes explanations that when panic attacks occur they are time limited and not life threatening.
69
Define Agoraphobia and treatment
Agoraphobia: a fear of or anxiety regarding places from which escape might be difficult. **most disabling of the phobias**
Treatment: -Supportive psychotherapy/ insight-oriented psychotherapy/- Behavior Therapy/ cognitive therapy/virtual therapy
70
Define specific phobia and treatment
an excessive fear of a specific object, circumstance, or situation.
Treatment: behavior therapy (most effective), exposure therapy
71
Define Social anxiety disorder (also referred to as social phobia) and treatment
- fear of social situations, including situations that involve scrutiny or contact with strangers.
- Treatment: Cognitive, behavioral, and exposure techniques are also useful in performance situations. Psychotherapy for social anxiety disorder usually involves a combination of behavioral and cognitive methods, including cognitive retraining, desensitization, rehearsal during sessions, and a range of homework assignments.
72
Define Generalized anxiety disorder and treatment
excessive anxiety and worry about several events or activities for most days during at least a 6-month period, worry is difficult to control and is associated with somatic symptoms
Treatment: Psychotherapy: directly. The major techniques used in behavioral approaches are relaxation and biofeedback.
73
Define Substance-induced disorder and treatment
direct result of a toxic substance, including drugs of abuse, medication, poison, and alcohol, among others.
Treatment: The primary treatment for substance-induced anxiety disorder is the removal of the causally involved substance. Treatment must focus on finding an alternative treatment
74
Define Mixed anxiety-depressive disorder and treatment
- both anxiety and depressive symptoms
- do not meet the diagnostic criteria for either an anxiety disorder or a mood disorder.
- combination of depressive and anxiety symptoms results in significant functional impairment for the affected person.
Treatment: clinicians are probably most likely to provide treatment based on the symptoms present, their severity, and the clinician's own level of experience with various treatment modalities.
75
What disorder is described below?
Also known as hypochondriasis-- a general, non-delusional preoccupation with fears of having, or the idea that one has, a serious disease based on the person’s misinterpretation of bodily symptoms
Somatic Symptom disorder
76
What are clinical features of somatic disorder?
Describe some treatments
These individuals have a poor insight about the presence of the disorder
Clinical features:
Augment and amplify their somatic sensations (over exaggerate their symptoms)
Low tolerance of physical discomfort
Often go into the “sick role” which offers an escape from life and then are excused from usual duties, postpone unwelcome challenges, and avoid noxious obligations
Treatment: they often resist care
Group psychotherapy-- prides social support, interactions, and reduce anxiety
Behavior therapy, CBT, hypnosis
May treat anxiety and depression with meds
77
Describe Illness anxiety disorder
- Persons who are preoccupied with being sick or developing an illness; few or no somatic symptoms
- These individuals are “primarily concerned with the idea that they are ill” and if they are sick, their anxiety is out of proportion to their diagnosis and assume the worst possible outcome imaginable
- They may maintain a belief that they have a particular disease, or as time progresses, they may transfer their belief to another disease
78
What's Functional Neurological Symptoms Disorder (Conversion Disorder)?
An illness of symptoms or deficits that affect voluntary motor or sensory functions-- these issues are caused by psychological factors because the illness is preceded by conflicts or other stressors
79
What are the 7 things listed in the PPT OT's can do to help someone with OCD ?
1. Recognizing signals: repetitive behaviors/ constant questioning
2. Modify expectations:moderate stress and expectations during times of transitions/change (Validate something in their life that is causing flare up)
3. Remember people get better at different rates
4. Avoid day to day comparisons ( things are difficulty today but tomorrow is a new day, new choices can be made- what can we do to make it better)
5. Recognize “small” improvements- every step is a big step, gives a sense of hope
6. Create a supportive environment-understand what OCD is and how to be supportive (from actual people who have OCD)
7. Set limits, but be sensitive to mood-
```
Also we can: Support taking medication
Keep communication clear and simple
Keep a normal routine
Beware of family accommodations
Having time to themselves
Consider a family contract
Don’t let it be all about the OCD- encourage conversation and opportunities that has nothing to do with the diagnosis.
```
80
Define Factitious Disorder
Definition: these patients simulate, induce, or aggravate illness to receive medical attention, regardless of whether they are ill
Example: they may inflict painful, deforming, or even life-threatening injury on themselves or their children
The primary motivator for them are to receive medical care and to be part of the medical system
81
What are clues trigger suspicion of factitious disorder?
What are some treatments?
Clues that trigger suspicion of factitious disorder:
unusual, dramatic presentation of symptoms that defy conventional medical or psychiatric understanding
Symptoms do not respond appropriately to usual treatment or medications
Emergence of new, unusual symptoms once other symptoms resolve
Eagerness to undergo a procedure or testing
Reluctance to give access to collateral sources of information
Extensive medical history
Multiple drug allergies
Medical profession
Few visitors
Ability to forecast unusual progression of symptoms
Treatment:
Reduce risk of mortality (e.g. the patients may ingest toxic chemicals to bring on medical attention)
To address underlying emotional needs
Caregiver education
82
What disorder is describe below?
marked by increased stress and anxiety following exposure to a traumatic or stressful event.
-stressful events may include being a witness to or being involved in a violent accident or crime, military combat, or assault, being kidnapped, being involved in a natural disaster, being diagnosed with a life-threatening illness, or experiencing systematic physical or sexual abuse.
PTSD and acute stress disorder
83
Define Depersonalization
Persistent or recurrent experiences of feeling detached from, and as if one were an outside observer of, one's mental processes or body
(e.g., feeling as though one were in a dream; feeling a sense of unreality of self or body or of time slowly).
84
Define Derealization
Persistent or recurrent experiences of unreality of surroundings
(e.g., the world around the individual is experienced as unreal, dreamlike, distant, or distorted).
85
Presence of nine (or more) of the following symptoms from any of the five categories of intrusion,
negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic
event(s) occurred:
What symptom is described below:
1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Note: In children, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.
2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the event(s). Note: In children, there may be frightening dreams without recognizable content.
3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) Note: In children, trauma-specific reenactment may occur in play.
4. Intense or prolonged psychological distress or marked physiological reactions in response to
internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
Intrusion Symptoms
86
Presence of nine (or more) of the following symptoms from any of the five categories of intrusion,
negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic
event(s) occurred:
What symptom is described below:
Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).
Negative Mood
87
Presence of nine (or more) of the following symptoms from any of the five categories of intrusion,
negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic
event(s) occurred:
What symptom is described below:
-Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).
Dissociative Symptoms
An altered sense of the reality of one's surroundings or oneself (e.g., seeing oneself from another's perspective, being in a daze, time slowing).
Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).
Negative Mood
88
Presence of nine (or more) of the following symptoms from any of the five categories of intrusion,
negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic
event(s) occurred:
What symptom is described below:
- An altered sense of the reality of one's surroundings or oneself (e.g., seeing oneself from another's perspective, being in a daze, time slowing).
- Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).
Dissociative Symptoms
89
Presence of nine (or more) of the following symptoms from any of the five categories of intrusion,
negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic
event(s) occurred:
What symptom is described below:
- Efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
- Efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
Avoidance Symptoms
90
Presence of nine (or more) of the following symptoms from any of the five categories of intrusion,
negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic
event(s) occurred:
What symptom is described below:
-Sleep disturbance (e.g., difficulty falling or staying asleep, restless sleep).
-Irritable behavior and angry outbursts (with little or no provocation), typically expressed as verbal or
physical aggression toward people or objects.
-Hypervigilance.
-Problems with concentration.-Exaggerated startle response.
Arousal Symptoms
91
Symptoms of the gulf war syndrome?
health problems, including irritability, chronic fatigue, shortness of breath, muscle and joint pain, migraine headaches, digestive disturbances, rash, hair loss, forgetfulness, and difficulty concentration upon return from the Persian gulf war
92
What disorder is described below? And what are some treatment ideas for this disorder?
characterized by an emotional response to a stressful event. It is one of the few diagnostic entities in which an external stressful event is linked to the development of symptoms. (ex: financial issues, a medical illness, or relationship problem)
Adjustment Disorder:
**short-term treatments aimed at helping persons with adjustment disorders resolve their situations quickly by supportive techniques, suggestion, reassurance, environmental modification,disorders. Group therapy
93
Define Dysthymia
| Define Cyclothymia
- atleast 2 years of depressed mood
| - atleast 2 yrs of hypomanic and depressive systems
94
Goals for bipolar are :safety, complete diagnostic, treatment plan
What are treatment ideas?
```
Hospitalization
Psychosocial therapy
Cognitive therapy
Interpersonal therapy
Behavior therapy
Psychoanalytically oriented therapy
Family therapy
Vagal nerve stimulation
Transcranial magnetic stimulation
Sleep deprivation
Phototherapy
Pharmacotherapy
```
95
What are the 7 things OT's can do to help someone with OCD ?
1. Recognizing signals: repetitive behaviors/ constant questioning
2. Modify expectations:moderate stress and expectations during times of transitions/change (Validate something in their life that is causing flare up)
3. Remember people get better at different rates
4. Avoid day to day comparisons ( things are difficulty today but tomorrow is a new day, new choices can be made- what can we do to make it better)
5. Recognize “small” improvements- every step is a big step, gives a sense of hope
6. Create a supportive environment-understand what OCD is and how to be supportive (from actual people who have OCD)
7. Set limits, but be sensitive to mood-
96
Define coping
Defined: Coping is the way we adjust to stressful demands in life.
97
4 Types of Stressors
1. Acute stressors = short-term event goes away quickly (e.x stung by a bee)
2. Stressor sequences = cascades of events (snowball affect) (e.x. 1 event causes another stressor)
3. Chronic intermittent stressors = intermittently over time (e.x work breaks down once in a while)
4. Chronic, permanent stressors = conditions over time (e.x. chronic illness in yourself or family member)
98
What are some interventions for coping?
Psychodynamic: •(writing/creative expression: free form art, drama, clay, finger paint)
Behavioral: Help with clients who need structure, reinforcement)
Cognitive Behavioral (Psychoeducation, Relaxation and meditation Health, Wellness, nutrition and Exercise Interpersonal skill training)
Child & Adolescent Intervention (help child build stable coping resources/styles, strategies)
99
What are the 3 types of coping strategies
1) behavioral strategies- involve some type of action to manage stress, such as confronting a person about a conflict or engaging in physical activity to manage the feelings
2) Avoidance: involve withdrawal, distraction, use of substances, or other methods of staying away from the stressor.
3) cognitive strategies- efforts to analyze the situation to fully understand the nature of the threat or challenge.
100
Schizophrenia: In the stable or maintenance phase, the illness is in a relative stage of remission
Goals during this phase are to prevent psychotic relapse and to assist patients in improving their level of functioning
Treatment for Schizophrenia includes: ?
```
Psychosocial therapies
Social Skills Training
Family-Oriented Therapies
Support Groups such as NAMI (National Alliance on Mental IIIness):
Group therapy
Cognitive behavioral therapy
Personal Therapy
Vocational Therapy
Art Therapy
cognitive training
```
101
OT Treatment for Major Depressive/ and Bipolar disorders are :
CBT: goal= reduce maladaptive behaviors that interfere with occupational roles
Interpersonal therapy: OT’s help clients improve social networks, role transitions, interpersonal disputes, social deficits, and maladaptive response to grief
Psychoanalytically oriented therapy: the goal is to change the person’s personality structure or character,
Family therapy
OT’s can help educate workplace managers about the impact of depression and bipolar
tx
OT’s can provide training in resilience and stress management
OT’s can provide materials and teach programs to recognize triggers to enhance self-management
Skills training
102
What are some treatment ideas for the following:
Anxiety and related disorders
Agoraphobia (fear regarding places)
Specific phobia (excessive fear of specific things)
Social anxiety disorder (fear of situations)
Generalized anxiety (excessive anxiety about everal events)
Treatment: Cognitive and behavior therapies are effective treatments for panic disorder. The information about panic attacks includes explanations that when panic attacks occur they are time limited and not life threatening. OT’s can work on ADL BADLs, coping strategies, look at sleep, hygiene, strategies to help the body engage in sleep, doing working on community mobility, help develop regulatory strategies.
Agoraphobia (fear regarding places) = supportive psychotherapy, insight-oriented psychotherapy, behavior therapy, cognitive therapy, virtual)
Specific phobia (excessive fear of specific things)= behavior therapy, exposure therapy, insight-oriented therapy
Social anxiety disorder (fear of situations) = Cognitive, behavioral, and exposure techniques are also useful in performance situations.
Generalized anxiety (excessive anxiety about everal events) = Psychotherapy: directly. The major techniques used in behavioral approaches are relaxation and biofeedback.
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OCD treatments (other than the ones mentioned previous card)
Behavior therapy:behavior therapy is as effective as pharmacotherapies in OCD,
Family Therapy
Psychotherapy
Other therapies (OT) : coping strategies, activity analysis, understanding triggers, what happens after the trigger,
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Treatments for PTSD
Treatment
When a clinician is faced with a patient who has experienced a significant trauma, the major approaches are support, encouragement to discuss the event, and education about a variety of coping mechanisms (e.g., relaxation).
Additional support for the patient and the family can be obtained through local and national support groups for patients with PTSD.
Group therapy has been particularly successful with Vietnam veterans and survivors of catastrophic disasters such as earthquakes.
Family therapy often helps sustain a marriage through periods of exacerbated symptoms.
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What's Granser syndrome
giving approximate answers together with a cloud of consciousness, usually accompanied with hallucinations and dissociative somatiform and conversion.
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Define Dissociative trance disorder
temporary but marked alteration in the state of consciousness or by loss of the customary sense of personal identification without replacement of an alternate sense of identity - no other identity, as in DID
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Define brainwashing
identity disturbance due to a prolonged and intense coercive persuasion
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What's recovered memory syndrome
recovered memory during treatment usually a reaction that is reliving traumatic event
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Treatments for eating disorders
| restricting/purging; Bulimia,
Cognitive-Behavioral Therapy: Patients are taught to monitor their food intake, their feelings and emotions, their binging and purging behaviors
Dynamic Psychotherapy: therapists must avoid excessive investment in trying
to change their eating behavior.
Family Therapy
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Somatic Symptom disorder:
| Treatments
reatment: they often resist care
Group psychotherapy-- prides social support, interactions, and reduce anxiety
Behavior therapy, CBT, hypnosis
May treat anxiety and depression with meds
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Functional Neurological Symptoms Disorder (Conversion Disorder)
Treatments
Treatment:
DO NOT tell them their symptoms are imaginary
Relaxation techniques, hypnosis, insight-oriented psychotherapy, develop a good therapeutic rapport
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Factitious Disorder
| treatment
Treatment:
Reduce risk of mortality (e.g. the patients may ingest toxic chemicals to bring on medical attention)
To address underlying emotional needs
Caregiver education
