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Mental Health > Chapter 2 Mental Health and Mental Illness > Flashcards

Chapter 2 Mental Health and Mental Illness Flashcards

1
Q

Some of the harmful effects of stigma toward those with mental health issues include:

A
  • Discrimination at work or school
  • Difficulty finding housing
  • Bullying, physical violence or harassment
  • Health insurance that doesn’t adequately cover a person’s mental health dysfunction/disorder
  • Instilling self-doubt regarding ability to succeed in certain challenges and perceiving that there is nothing that can help
  • Further isolation from friends, family, and colleagues.
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2
Q

Mental health and mental illness are not specific entities but rather they exist on a continuum. The mental health continuum is?

A

dynamic and ever-shifting, ranging from mild to moderate to severe to psychosis

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3
Q

The groundbreaking Report of the Surgeon General (USDHHS, 1999) defines mental health as successful performance of?

A

mental functions, resulting in the ability to engage in productive activities, enjoy fulfilling relationships, and adapt to change and cope with adversity.

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4
Q

Mental health is from early childhood until death

A

“the springboard of thinking and communication skills, learning, emotional growth, resilience, and self-esteem”

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5
Q

Mental health is a state of well-being in which individuals are able to realize their?

A

abilities within the normal stresses of life and function productively within their personal lives as well as contribute to their community

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6
Q

According to the National Alliance on Mental Illness (NAMI, 2011) mental illnesses are medical conditions that affect a person’s?

A

thinking, feeling, mood, ability to relate to others, and daily functioning. Basically, mental illness can be seen as the result of a chain of events that include flawed biological, psychological, social, and cultural processes. However, mental illnesses are treatable, and individuals can experience relief from their symptoms with treatment and support.

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7
Q

Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is the manual that classifies mental disorders and is considered the “bible” for mental health workers (e.g., psychiatrists, psychiatric nurses, psychologists, and others who plan care for people experiencing mental distress/dysfunction). The DSM focuses on?

A

research and clinical observation when constructing diagnostic categories for a discrete mental disorder.

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8
Q

Attributes of mental health

A
  • ability to love and experience joy
  • capacity to deal with conflicting emotions
  • ability to live without (undue) fear, guilt, anxiety
  • ability to take responsibility for one’s own actions
  • ability to control one’s own behavior
  • think clearly (problem solve, use good judgment, reason logically, reach insightful conclusions, be creative)
  • relate to to others (form relationships, have close, loving adaptive relationships, experience empathy towards others, manage interpersonal conflict constructively)
  • attain self defined spirituality
  • negotiate each developmental task
  • ability to work and be productive
  • maintain a healthy self concept and self value
  • ability to play and laugh
  • accurate appraisal of reality
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9
Q

The World Health Organization declared that 4 of the 10 leading causes of disability in the United States and other developed countries are?

A

mental health disorders

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10
Q

all human behavior lies somewhere along a continuum of?

A

mental health and mental illness

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11
Q

One myth is that to be mentally ill is? Another misconception is that to be mentally healthy, a person must be?

A
  • One myth is that to be mentally ill is to be different and odd.
  • Another misconception is that to be mentally healthy, a person must be logical and rational. All of us dream “irrational” dreams at night, and “irrational” emotions not only are universal human experiences but also are essential to a fulfilling life.
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12
Q

Psychiatry’s definition of normal mental health changes over time and reflects changes in?

A

cultural norms, society’s expectations and values, professional biases, individual differences, and even the political climate of the time.

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13
Q

A characteristic of mental health that is increasingly being promoted is the concept of?

A

resiliency

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14
Q

Resiliency is the ability to?

A

Recover from or adjust easily to misfortune and change. Resiliency is closely associated with the process of adapting and helps people facing tragedy, loss, trauma, and severe stress

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15
Q

Being resilient does not mean that people are unaffected by stressors. It means that rather than falling victim to the negative emotions, resilient people recognize the?

A

feelings, readily deal with them, and learn from the experience given time

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16
Q

some important aspects of mental health with those of specific mental disorders. These aspects include degree of

A

(1) happiness, (2) control over behavior, (3) appraisal of reality, (4) effectiveness in work, (5) healthy self-concept, (6) satisfying relationships, and (7) effective coping strategies.

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17
Q

Epidemiology is the quantitative study of the distribution of disorders in human populations. Once the distribution of mental disorders has been determined quantitatively, epidemiologists can identify?

A

high-risk groups and high-risk factors. Study of these high-risk factors may lead to important clues about the etiology of various mental disorders.

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18
Q

Clinical epidemiology is a broad field that addresses the outcomes of people with illnesses who are seen by providers of clinical care. Studies use?

A

traditional epidemiological methods and are conducted in groups that are usually defined by illness or symptoms, or by diagnostic procedures or treatments given for the illness or symptoms.

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19
Q

The prevalence rate is the proportion of a population with a mental disorder at a given time. Kessler and colleagues (2005) latest study of the lifetime prevalence of mental disorders and concluded in their survey that about half of Americans will meet the criteria for a DSM disorder sometime in their life, with the first onset in?

A

childhood or adolescence. It is important to note that many individuals have more than one mental disorder at a time. For example, some people diagnosed with a depressive disorder may also have a coexisting anxiety disorder. Therefore some people have dual diagnoses (coexisting disorders).

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20
Q

Many factors can affect the severity and progress of a mental illness, biologically based or otherwise, and these same factors can affect a “normal” person’s mental health as well. Some of these factors include?

A

available support systems, family influences, developmental events, cultural or subcultural beliefs and values, health practices, and negative influences impinging on an individual’s life. If possible, these influences need to be evaluated and factored into an individual’s plan of care.

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21
Q

Affects men and women equally; may appear earlier in men than in women

A

Schizophrenia 2.2 million

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22
Q

Women affected twice as much as men (12.4 million women; 6.4 million men); depressive disorders may appear earlier in life in those born in recent decades compared with past; often co-occurs with anxiety and substance abuse

A 
Any affective (mood) disorder; includes major depression, dysthymic disorder, and bipolar disorder
18.8 million
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23
Q

Leading cause of disability in the United States and established economies worldwide; nearly twice as many women (6.5%) as men (3.3%) suffer from a major depressive disorder every year

A

Major depressive disorder

9.9 million

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24
Q

Affects men and women equally

A

Bipolar affective disorder

2.3 million

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25
Q

Anxiety disorders; includes panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder (PTSD), generalized anxiety disorder, and phobias

A

19.1 million

Anxiety disorders frequently co-occur with depressive disorders, eating disorders, and/or substance abuse

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26
Q

Panic disorder

A

2.4 million

Typically develops in adolescence or early adulthood; about one in three people with panic disorder develops agoraphobia

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27
Q

Obsessive-compulsive disorder

A

3.3 million

First symptoms begin in childhood or adolescence

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28
Q

PTSD

A

5.2 million

Can develop at any time; approximately 30% of Vietnam veterans experienced PTSD after the war; percentage high among first responders to 9/11/01 terrorist attacks

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29
Q

Generalized anxiety disorder

A

4 million

Can begin across life cycle; risk is highest between childhood and middle age

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30
Q

Social phobia

A

5.3 million

Typically begins in childhood or adolescence

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31
Q

The 1999 USDHHS report entitled Mental Health: A Report of the Surgeon General stated the following:

A
  • Mental health is fundamental to health.
  • Mental disorders are real health conditions that have an immense impact on individuals and families.
  • The efficacy of mental health treatment is well documented.
  • A range of treatments exists for most mental disorders.
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32
Q

One method many states use to determine coverage is by making a distinction of whether the problem is a biologically based mental illness, that is, a mental disorder caused by?

A

neurotransmitter dysfunction, abnormal brain structure, inherited genetic factors, or other biological causes. Another term for such an illness is psychobiological disorder.

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33
Q

psychobiological disorder. These biologically influenced illnesses include the following:

A
  • Schizophrenia
  • Bipolar disorder
  • Major depression
  • Obsessive-compulsive and panic disorders
  • Posttraumatic stress disorder
  • Autism
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34
Q

Other severe and disabling mental disorders include the following:

A
  • Anorexia nervosa
  • Attention deficit/hyperactivity disorder
  • Many of the most prevalent and disabling mental disorders have been found to have strong biological influences; therefore we can look at these disorders as “diseases.”
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35
Q

The DSM cautions that the emphasis on the term mental disorder implies a distinction between “mental” disorder and “physical” disorder, which is an outdated concept, and stresses mind-body dualism:

A

“There is much ‘physical’ in ‘mental’ disorders and much ‘mental’ in ‘physical’ disorders”

36
Q

In the DSM each of the mental disorders is conceptualized as a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and is associated with?

A

present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.

37
Q

It is important to stress that the DSM classifies disorders that people have, and not the person. For this reason, the text of the DSM avoids the use of expressions such as “a schizophrenic” or “an alcoholic” and instead uses the more accurate terms?

A

“an individual with schizophrenia” or “an individual with alcohol dependence.”

38
Q

Spirituality is a much broader concept than just religion alone; spirituality

A

“provides an essential core, enriching experience, and a reason to live for many people”

39
Q

Favazza (2009) cites the following examples of how people obtain an altered state of consciousness, which is spiritually enriching and brings peace and serenity into people’s lives.

A

Mysticism, meditation (e.g., Dhyana, a form of concentrated meditation taught by Buddha; Zen Buddhism, a Japanese practice in which a spiritual master instructs students in meditation, used throughout the United States; and transcendental meditation, a Hindu meditative process), and mindfulness meditation (derived from Buddhist practice) are just a few examples.

40
Q

Mindfulness meditation is used today and has many health benefits; it is a valuable tool for dealing with chronic pain and stress. It is actively employed with?

A

dialectic behavioral therapy (DBT), stress reduction programs, and some forms of cognitive therapy

41
Q

most widely used in the United States; it is used for many reasons and is also tied to many different cultures.

A

Prayer

42
Q

The DSM axis system forces the diagnostician to consider a broad range of information by requiring judgments to be made on each of five axes.

A
  • Axis I: collection of signs and symptoms that constitute particular disorder (for example, schizophrenia) or a condition that may be a focus of treatment
  • Axis II: personality disorders and mental retardation.
  • Axes I and II constitute classification of abnormal behavior
  • Axis III the clinician indicates any general medical conditions believed to be relevant to the mental disorder in question
  • Axis IV is for reporting psychosocial and environmental problems that may affect the diagnosis, treatment, and prognosis of a mental disorder. These may include occupational problems, educational problems, economic problems, interpersonal difficulties with family members, and a variety of problems in other life areas
  • Axis V, called Global Assessment of Functioning (GAF), gives an indication of the person’s best level of psychological, social, and occupational functioning during the preceding year, rated on a scale of 1 to 100 (1 indicates persistent danger of severely hurting oneself or others, and 100 indicates superior functioning in a variety of activities at the time of the evaluation, as well as the highest level of functioning for at least a few months during the past year)
43
Q

Stigma is a?

A

“collection of negative attitudes, beliefs, thoughts, and behaviors that influence the individual, or the general public, fear, reject, or avoid, be prejudiced, and discriminate people”

44
Q

Goffman’s classic definition of stigma is

A

“an attribute that is deeply discrediting where a person is reduced from a whole unusual person to a tainted, discounted one”

45
Q

psychosocial processes that lead to stigmatization

A

Stereotyping, labeling, separating, status, loss, and discrimination in a context of power imbalance are many of the psychosocial processes that lead to stigmatization.

46
Q

GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗

100>91

A

Superior functioning in a wide range of activities, life’s problems never seem to get out of hand, is sought out by others because of his or her many positive qualities. No symptoms.

47
Q

GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗

90>81

A

Absent or minimal symptoms (e.g., mild anxiety before an exam), good functioning in all areas, interested and involved in a wide range of activities, socially effective, generally satisfied with life, no more than everyday problems or concerns (e.g., an occasional argument with family members).

48
Q

GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗

80>71

A

If symptoms are present, they are transient and expected reactions to psychosocial stressors (e.g., difficulty concentrating after family argument); no more than slight impairment in social, occupational, or school functioning (e.g., temporarily falling behind in schoolwork).

49
Q

GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗

70>61

A

Some mild symptoms (e.g., depressed mood and mild insomnia) OR some difficulty in social, occupational, or school functioning (e.g., occasional truancy, or theft within the household), but generally functioning pretty well, has some meaningful interpersonal relationships.

50
Q

GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗

60>51

A

Moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) OR moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or coworkers).

51
Q

GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗

50>41

A

Serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) OR any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job).

52
Q

GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗

40>31

A

Some impairment in reality testing or communication (e.g., speech is at times illogical, obscure, or irrelevant) OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood (e.g., depressed man avoids friends, neglects family, and is unable to work; child frequently beats up younger children, is defiant at home, and is failing at school).

53
Q

GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗

30>21

A

Behavior is considerably influenced by delusions or hallucinations OR serious impairment in communication or judgment (e.g., sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) OR inability to function in almost all areas (e.g., stays in bed all day; no job, home, or friends).

54
Q

GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗

20>11

A

Some danger of hurting self or others (e.g., suicide attempts without clear expectation of death; frequently violent; manic excitement) OR occasionally fails to maintain minimal personal hygiene (e.g., smears feces) OR gross impairment in communication (e.g., largely incoherent or mute).

55
Q

GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗

10>1

A

Persistent danger of severely hurting self or others (e.g., recurrent violence) OR persistent inability to maintain minimal personal hygiene OR serious suicidal act with clear expectation of death.

56
Q

GLOBAL ASSESSMENT OF FUNCTIONING (GAF) SCALE∗

0

A

Inadequate information.

57
Q

Psychiatric mental health nursing includes the diagnosis and treatment of human responses to?

A

actual or potential mental health problems.

58
Q

NANDA International (NANDA-I) describes a nursing diagnosis as a?

A

clinical judgment about individual, family, or community responses to actual or potential health problems and life processes.

59
Q

the DSM is used to diagnose a psychiatric disorder, whereas a well-defined nursing diagnosis provides the framework for identifying?

A

appropriate nursing interventions for dealing with the phenomena a patient with a mental health disorder is experiencing (e.g., hallucinations, self-esteem issues, impaired ability to function).

60
Q

The DSM includes information specifically related to culture in three areas:

A
  1. A discussion of cultural variations for each of the clinical disorders
  2. A description of culture-bound syndromes
  3. An outline designed to assist the clinician in evaluating and reporting the impact of the individual’s cultural context
61
Q

Cultures differ not only in the way they view mental illness but also in the types of behavior categorized as mental illness. For example, the content of a person’s delusions, hallucinations, obsessional thoughts, and phobias often reflects?

A

what is important in the person’s culture.

62
Q

A number of culture-related syndromes appear to be more influenced by culture alone and are not seen in all areas of the world. For example, one form of mental illness recognized in parts of Southeast Asia is running amok, in which someone?
- Pibloktoq is an uncontrollable desire to?
-

A

(usually a male) runs around engaging in furious, almost indiscriminate violent behavior.
- Pibloktoq is an uncontrollable desire to tear off one’s clothing and expose oneself to severe winter weather; it is a recognized form of psychological disorder in parts of Greenland, Alaska, and the Arctic regions of Canada.
-

63
Q

Many believe that the helpers of choice for many people from minority cultures are their traditional helpers/therapists. This is particularly true for problems that have psychological or psychosocial aspects. One example would be people of Central and Latin American cultures. Many people from this area of the world may prefer?

A

curanderos (male healers) or curanderas (female healers), who would be sought for healing a number of symptoms that are perceived to originate from psychological components, such as susto (fright) and mal de ojo (evil eye)

64
Q

Another example is that of the Mexican and Mexican Americans who primarily prefer?

A

female healers. The practices employed by these healers are a mixture of Catholicism, ancient Mayan and Aztec cultures, and herbology

65
Q

psychotherapy would be considered the treatment of last resort in many cultures because?

A

(1) it is unavailable, (2) shame is attached to using therapies in the dominant culture, or (3) there are more effective or preferred treatments in their own culture

66
Q

The most effective therapists will be those who are eclectic in their?

A

knowledge, come from a background of working with different cultures, have a broad knowledge of coping strategies, and are flexible in their approach

67
Q

What is stigma?

The American Heritage Dictionary (1991) defines stigma as

A

“a mark of infamy, disgrace or reproach.” People often feel that stigma disqualifies one from full social acceptance. Many groups are stigmatized in our society

68
Q

What are the effects of stigma?

Stigma and discrimination against people with mental illness are often major barriers to success in?

A

relationships, employment, and treatment programs. Even worse, efforts to achieve rehabilitation and recovery from mental illness can be sabotaged by prejudice and negative assumptions. The availability of health care in general is also affected by the stigma of mental illness. People with mental illness receive fewer medical services than those not labeled in this manner

69
Q

Mental health can be conceptualized along a continuum, from?

A

mild to moderate to severe to psychosis.

70
Q

There are many important aspects of mental health

A

happiness, control over behavior, appraisal of reality, effectiveness in work, a healthy self-concept, presence of satisfying relationships, and effective coping strategies

71
Q

The processes that lead to stigmatization (labeling, stereotyping, status, loss, and discrimination in a context of power imbalance) can lead to an increase in?

A

social isolation, an enhanced struggle to recover, poor social functioning, significant barriers to obtaining psychiatric and medical services, and more. The mental anguish and excruciating pain caused by stigmatization effect tremendous damage to individuals and their families, groups, and/or cultures.

72
Q

The study of epidemiology can help identify?

A

high-risk groups and behaviors. In turn, this can lead to a better understanding of the causes of some disorders. Prevalence rates help us identify the proportion of a population with a mental disorder at a given time.

73
Q

Clinicians use the five axes of the DSM and the GAF scale as a guide for?

A

diagnosing and categorizing mental disorders, allowing for a more holistic approach to the assessment. Medical condition, psychosocial and environmental influences, and present and past levels of functioning are considered.

74
Q

Using well-conceived nursing diagnoses helps target the symptoms and needs of patients so that ideally they may achieve a?

A

higher level of functioning and a better quality of life.

75
Q

The influence of culture on behavior and the way in which symptoms present may reflect a person’s?

A

cultural patterns. Symptoms need to be understood in terms of a person’s cultural background.

76
Q

Caution is recommended for all health care professionals concerning the damage and disservice that stigmatizing/stereotyping can cause for medical and mental health patients. Stigmatizing is acknowledged to be a barrier to?

A

proper or appropriate mental health/recovery and medical services as well. Indeed, it may even prevent a person from accessing or receiving help. Stigmatizing/stereotyping causes shame and pain for the individual and their families, or the groups being stigmatized, and greatly impacts the quality of life or ability to lead a healthy life.

77
Q

Mental illness is defined in relation to the?

A

culture, time in history, political system, and group in which it occurs.

78
Q

Axis V of the DSM multiaxial system:

  1. refers to medical illnesses.
  2. reports psychosocial and environmental problems.
  3. indicates a need for substance abuse treatment.
  4. describes a person’s level of functioning.
A

4.describes a person’s level of functioning.

79
Q

Why is it important for a nurse to be aware of the multiple factors that can influence an individual’s mental health?

A

The nurse diagnoses and treats human responses, which are influenced by many factors.

80
Q

Factors that affect a person’s mental health are: (select all that apply)

  1. support systems.
  2. developmental events.
  3. socioeconomic status.
  4. cultural beliefs.
A
  1. support systems.
  2. developmental events.
  3. cultural beliefs.
81
Q

The DSM-IV-TR diagnosis distinguishes a person’s specific psychiatric disorder, whereas a nursing diagnosis offers a framework for identifying interventions for phenomena a patient is experiencing.

A

.

82
Q

Which question will the nurse ask in order to assess a client’s ability to think clearly?
“Are you employed full time?”
“Do you feel guilty about your recent divorce?”
“How do you plan to afford getting your own apartment?”
“What do you think is your most valuable personal characteristic?”

A

“How do you plan to afford getting your own apartment?”

Clear thinking is demonstrated by the ability to problem solve using good judgment and logically reasoning to arrive at an insightful conclusion. Clear thinking would be demonstrated by arriving at a plan to live independently that demonstrates those qualities. Employment demonstrates productivity; identifying valuable personal characteristics is associated with a healthy sense of self-value; undue guilt reflects ability to manage anxiety and fear.

83
Q

The nurse, striving to minimize the bias of a Western view on what is considered acceptable behavior, will consult which mental health associated resource?

  • Cultural Formulation Interview (CFI)
  • Glossary of Cultural Concepts of Distress
  • The client’s past and present mental health assessment
  • The Diagnostic and Statistical Manual of Mental Disorders
A

Cultural Formulation Interview (CFI)

The CFI assesses the client’s cultural perception of distress, social supports such as family and religion, and relationship factors between the patient and provider including language and discrimination experiences in the societal majority. While useful resources, none of the remaining options focus on these cultural perceptions.

84
Q 
When considering prevalence, the nurse will focus on which disorder(s) when identifying the focus of a community mental health screening?
  Anxiety disorders
  Affective disorders
  Alcohol dependence
  Any substance abuse
A

Anxiety disorders
Over a 12-month period, anxiety disorders have an 18.1% prevalence affecting an estimated 57 million people. Affective disorders 9.5% (30 million); alcohol dependence 6.3% (16.5 million); any substance abuse 9.4% (24.6 million).

85
Q

The nurse recognizes that the greatest barrier to successful mental health treatment and recovery is demonstrated by which client?
The teenager who fears being rejected by his peers
The young homeless adult who cannot keep clinic appointments
The elderly Syrian immigrant who speaks only minimal English
The middle-aged adult who cannot afford prescription medication

A

The teenager who fears being rejected by his peers

Stigma is defined as a collection of negative attitudes, beliefs, and thoughts that influence public perception of the mentally ill. Stigma contributes to fear, rejection, and discrimination against the mentally ill that taint and discount the individual, and stigma has been acknowledged as a major barrier to mental health treatment and recovery. The teenager is afraid of being stigmatized by peers and so is much less likely to seek and/or comply with mental health treatment. The remaining options demonstrate barriers but none are as powerful as stigma.

Mental Health (8 decks)

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