- hallucinations - delusions - disorganized speech - thought disorder - disorganized behavior

- alogia (no speech) - flat affect - poor attention - avolition (no motivation) - anhedonia (no pleasure) - loss of social interest - attention defecits

Week 3- psychosis/crisis intervention Flashcards by abby wright

psychosis

definition

disruptions to a persons thoughts and perceptions that make it difficult to recognize what is real and what isnt

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psychosis DSM-5 definition

abnormalities in 5 different symptomatic domains

delusions
hallucinations
disorganized thoughts/speech
disorganized behavior
negative symptoms

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psychosis physiology

no one cause but thought to deal with lack of dopamine which leads to positive symptoms
- can be due to environment, toxins, genetics
- usually develops early to late 20’s due to amount of stress during this time

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schizophreniform disorder

duration

1- 6 months

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schizophrenia

duration

symptoms last longer than 6 months

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schizoaffective disorder

psychosis with a mood disorder
- there will be psychosis at all times

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disorders that may manifest psychosis

bipolar disorder I, major depressive disorder, alcohol use disorder, substance use disorder

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secondary psychosis

product of underlying medical problems

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schizophrenia diagnostic criteria

2 or more of the following;
- delusions
- hallucinations
- disorganized speech
- disorganized behavior
- negative symptoms

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delusions

false, fixed beliefs that are unlikely to change despite contradictory evidence

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hallucinations

perceptions that occur without an external stimulus
- auditory is most common

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positive symptoms

hallucinations
delusions
disorganized speech
thought disorder
disorganized behavior

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negative symptoms

alogia (no speech)
flat affect
poor attention
avolition (no motivation)
anhedonia (no pleasure)
loss of social interest
attention defecits

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1st phase of psychosis

subtle early signs
vague changes in thoughts/feelings/perceptions
able to maintain some level of functioning

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2nd phase of psychosis

clear psychotic signs
functioning deteriorates
substance abuse for coping is common
high risk of suicide due to lots of frustration

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3rd phase of psychosis

treatment/recovery
medication
social supports and resources
relapse is common

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consequences of psychosis

problems with functional ability
dementia
long term problems related to pharmacological treatment

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grandiose delusions

belief of special powers or of being greatly significant

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paranoid delusions

reflect profound fear and anxiety

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control delusions

do not feel in control of their movement

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somatic delusions

deals with feelings in body
- eg. parasites

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nihilistic delusions

believes they are dead

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magical thinking

believes that specific thoughts/words have special influence on world around them

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command halluciantions

voice telling you to do something

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circumstantial thought

gives excessive and non-essential detail but returns to point or answers question

tangential thought

never returns to topic

loose associations

lack of logical relationship betwen thoughts

flight of ideas

rapid change from one topic to another

thought blocking

sudden pause in train of thought and then cannot recall

preservation

persisting on topic even when stimulus has changed

clang association

similar sounds but incoherent meaning

echolalia

repetition of things said by others

neologisms

making up words

word salad

incoherent mixture of words

waxy flexibility

body showing resistance to being moved - specific symptom of catatonia

stereotypy

repetitive or ritualistic movement or posture

echopraxia

involuntary repetition or imitation of another persons actions

alogia

poverty of speech

avolition

decreased motivation

anhedonia

inability to feel pleasure

ambivalence

strong opposing feelings

acute phase interventions | psychosis

safety, establish trust, do not confirm delusions or hallucinations

recovery phase interventions | psychosis

show positive regard for experience, focus on goal oriented activity, model appropriate skills

first generation antipsychotics

most common is haldol; least expensive - treats positive symptoms - not for long term - side effects are parkonsinism, NMS, dystonia, akathisia

neuroleptic malignant syndrome

mental status change with muscle rigidity and fever

dystonia

involuntary muscle contraction

akathisia

inability to remain still

2nd generation antipsychotics

clozapine, olanzapine, risperidone, palperidone - treats positive and negative symptoms but much more expensive - very potent - can cause side effects but lesser degree than 1st gen * can cause agranulocytosis

3rd generation antipsychotics

aripiprazole (abilify) - treat mood disorders and schizophrenia - can cause side effects but lesser degree than 1st or 2nd gen - expensive

meds to manage side effects for antipsychotics

benztropine and clonazepam

purpose of crisis intervention

goal is rapid resolution to prevent further deterioration

stages of a crisis

precipitant --> early escalation --> meet needs --> cope

initial threat | stage of crisis

problem where patient has to cope

escalation | stage of crisis

problem persists and usual defensive coping skills fails

crisis | stage of crisis

fight or flight response and may attempt to find helpful resources

personal disorganization | stage of crisis

if problem is unresolved from 2nd or 3rd stage then there will be serious disorganization

situational crisis

things related to immediate life circumstances

maturational crisis

related to stages of life

adventitious crisis

related to natural disasters, acts of terrorism, interpersonal disaster

key to crisis intervention | 3

empowerment, empathy, interdisciplinary

stage 1 crisis intervention | crisis assessment

- level of functioning and current safety - suicide risk assessment

stage 2 crisis intervention | establish rapport

- may need to use de-escelation techniques - active listening - empathy - role clarity - boundaries

stage 3 crisis intervention | identify major problems

- identify major problems - client perspective on the situation

stage 4 crisis intervention | feelings and emotions

- education - empower - positive reframing

stage 5 crisis intervention | explore alternatives

- avoid probing in depth - ask what strategies work for them - offer choice

stage 6 crisis intervention | develop plan

- collaborative agreement on a plan - focus on basic needs - implement the plan

illusion

misperception of a real experience or stimulus

Week 3- psychosis/crisis intervention Flashcards

(68 cards)