Assesment, Dx, And Intervention Planning Flashcards
Can schizophrenia be diagnosed with without psychotic symptoms?
No
Do Psychotic symptoms indicate schizophrenia?
No, it could be a number of mental diagnosis.
How long does brief psychotic disorder last?
Less than 1 month
How long does schizophreniform disorder last?
Less than 6 months
Schizophrenia must has a psychotic behavior of greater than __months
6
This disorder requires at least one period of mania.
Bipolar 1.
This is a phobic reaction of anxiety related to separation from parents
Separation anxiety disorder which occurs at 6/7 months to 12/16 months.
Substance induced anxiety disorder or substance induced mood disorder is______?
A panic attack caused by a substance.
Anxiety disorder or mood disorder due to general med condition is______?
A panic attack caused by a medical illness.
Thoughts are Not as senseless or intrusive, meaningful to the patient.
Obsessive brooding
Irrational thoughts that can’t stop
Obsessions
True or false: antisocial personality disorder can only be diagnosed after 18. However, the symptoms but be present prior to age 15.
True
True or false. Antisocial symptoms prior to the age of 18 is conduct disorder.
True
Delusional disorder does not produces less impairments than paranoid schizophrenia.
False. Delusions occur in both but paranoid schizophrenics are more prominent or bizzare.
Drug/alcohol intoxication, withdrawal, abuse and dependent are?
Substance related disorders
PTSD, acute stress disorder, adjustment disorder, bereavement are all what?
4 disorders that are defined by reaction.
Personality disorders, schizophrenia (>6 mos) dysthymia, cyclothymic disorder (>_ 2 yrs), gen anxiety disorder, hypochondriasis, somatizarion disorder are all chronic
True
Long term depression
Dysthymia disorder
“Mild bipolar” less extreme highs and lows
Cyclothymic disorder (greater equal to 2 yrs)
Long term physical symptoms but no physical cause.
Somatization disorder
Shane has this
Parasomnia: abnormal event that happens between sleep and waking.
What is disturbance in amount, timing, or quality of sleep.
Dyssomnia
Viagra helps this
Sexual dysfunction: impairment of sexual response.
Term used for inappropriate sexual object or practice
Paraphilia
Disturbance in amount, timing, or quality of sleep (new mothers)
Dyssomnia
Changes in appetite and weight, sleep disturbances, fatigue, decrease in energy, decrease in sexual desire and function.
“Classic” symptoms of depression, neurovegitative symptoms.
This disorder is the actual loss of motor function or symtoms of voluntary motor function. The patient does not produce or control them voluntarily. (Numbness, blindness)
Conversion disorder
Malingering
Fakes symptoms to obtain external reward
Patient produces symptoms due to psychological need to adopt the “sick role”
Munchausen’s
A parent who feeds a child lead to produce medical symptoms.
Munchausen’s by proxy
Schizotypal personality disorder
Magical thinking associated with it
This diagnosis can look like mania
Hyperthyroidism
This can look like depression
Hypothyroidism
Disturbance involving memory impairment and other cognitive impairments. Becomes worse over time.
Dementia
Changes in levels of consciousness and orientation. Rapid or acute onset.
Delirium
Odd and eccentric personality disorders.
Paranoid, schizotypal and schizoid.
Cluster a
Dramatic and emotional and erratic personality disorders. Borderline antisocial, histrionic, and narcissistic.
Cluster b
Anxious and fearful.
Avoidant, dependent, and obsessive-compulsive
Cluster c
Disturbance or change in the usually integrative functions if memory, identity, perception, or consciousness.
Dissociation.
Comorbid
Existing at the same time.
Endogenous depression
Depression caused by biochemical imbalance not psychosocial stressor.
Exogenous depression
Caused by external events or psychosocial stressors
Folie a deux
Shared delusion: a person develops a delusion as a result of a relationship with Simone who also has an established delusional system.
Hypo manic
Less severe than manic symptoms. I.e. Elevated expansive or irritable mood,
Prod roman
Time before onset of serious illness during which there may be subtle symptoms.
Which personality disorder is characterized by a pattern of irrational suspicion and mistrust of others.
Paranoid personality disorder.
Lack of interest and detachment from social relationships, apathy and restricted emotional expression.
Schizoid personality disorder.
A pattern if extreme discomfort interacting socially distorted cognition san perceptions
Schizotypal personality disorder Cluster a (odd$)
Pervasive pattern of disregard for and violation of the right of others, lack if empathy, bloated self image, manipulative and impulsive behavior
Antisocial personality disorder.
Pervasive pattern if instability in relationships, self image, identity and behavior and affects often leading to self ahem and impulsivity
Borderline personality disorder.
Attention seeking behavior and excessive emotions
Histrionic personality disorder
Grandiosity, need for admiration and a lack of empathy.
Narcissistic personality disorder.
Cluster c
Pervasive feeling if social inhibition and inadequacy, extreme densities ti negative evaluation
Avoidant personality disorder.
Cluster c
Pervasive psychological need to be cared for by other people
Dependent personality disorder
Cluster c
Rising is conformity to rules perfectionism and control
Obsessive compulsive personality disorder. Cluster c
Post traumatic stress disorder
Exposure to traumatic event. Symptoms include flashbacks, increased arousal, avoidance if stimuli associated with the trauma.
Impulse control disorder
Failure to resist an impulsive act or behavior maybe harmful to self or others not considered in advanced and no control of it.
Agoraphobia
Fears about being in situations or places where escape would be embarrassing or difficult or help not available if panic attack occurs.
Condition characterized by a failure to remain attentive in various situation. Requires symptoms to occur in 2 different settings. It can increase with stress and decrease when in a controlled situation.
ADHD
A young persons who have a pattern of conduct which violates basic rights of others, social norms or rules.
Conduct disorder
Aggressive behavior displayed passively and provokes other adults or children. They do not violate the rights of others. The defiance interferes with their ability to function in school/home/community.
Oppositional disorder
4 symptoms
Losing temporary, arguing, refusing to follow rules, deliberately annoying people, blaming others
School phobia is a form of_______?
Separation anxiety.
The longer the child is able to stay out of school the more severe their social and educational impairments become.
Children who avoid establishing new interpersonal conte or relationships with strangers to the extent that there is noticeable interference with developing peer relationships and social functioning. They may have normal relationships with familiar people.
Avoidant behavior
Fears and worries are not traceable to specific problems or stresses. Anxiety may be expressed as physiological symptoms.
Over anxious disorder
Irrational Fear of specific object activity or situation. Starts as teen or early adult.
Simple phobia
Developmental disorders
Disturbance/delay in one area of development (motor, language, social, cognitive)
Pervasive development disorder
Multiple areas of development are affected
Autism
Developed before age 3. Fails to develop usual social relationship, eye contact, avoids eye contact, defaults to smile, may be non verbal have evholalia. Have rigid play, may have over or under responsiveness to sensory stimuli like sound or pain. It occurs 4-5x more in males.
Bipolar disorder I children
Mania and depression. Mania may include euphoria, unusually good mood and it impacts normal activities and relations with others.
Childhood depression/ major depressive episode
May manifest differently in Children than adults but can appear the same. It can also make Children irritable, fail to gain weight, feign illness, refuse to school, express fears that parents may die.
Behavioral a and somatic symptoms are most prominent in children and adolescents 80% of teen suicides are linked to?
Depression
Identity disorder in children?
Severe distress over inability to integrate aspects of self
Adjustment disorder in children
Maladaptive reaction (conduct/mood disturbance, physical symptoms, impairment of functioning) to identifiable source if stress (divorce, death, etc)
Elimination disorder that involves pooping in inappropriate places. It must occur in child over 4,once a month for 3 months.
Encopresis
Involves motor behavior that us driven, repetitive, without function and interferes with activities. Has the potential to cad self harm
Stereotypic movement disorder
Female disorder in which developmental regression occurs after normal development has happened
Rhett’s disorder
Delays in social interaction and restricted repetitive patterns if behavior interests and activities. More common in boys
Aspergers disorder
Reactive attachment disorder
Effect of Gross deprivation of care or multiple caregivers.
Can be inhibited or dis inhibited
In- refuses to initiate or respond to social interaction.
Dis- superficially accepts anyone as caregiver
True or False: A family history of alcoholism is the strongest predictor for developing an alcohol problem?
True
True or False: Females with High SES are the most at risk for drug/alcohol abuse.
False, male, inner city or rural residence with low SES and lack of employment are at most risk.
This is a holistic model that uses hereditary predisposition, emotional.psychological problems. social influences and environmental problems to explain why substance abuse happens.
biopsychosocial model
This model states that substance abuse is caused by genetics, altered brain chemistry, and brain reward mechanisms.
Medical/biological model
This model believes that substances relieve symptoms of a psychiatric disorder and continued use is reinforced by relief of symptoms
Self-medication
This model explains that substance abuse is caused by behaviors shaped by family and peers, disorganized communities, school factors.
Family and Environmental Model
This model explains that substance abuse is linked to emotional problems and that substances are used to escape painful problems of life.
The clinical model
This model explains that susbtance abuse is learned and reinforced from members of subculture who serve as role models. They share the same values and activities as other who use substances
social model
True or False: substance abuse assessments are used to gather info and establishing a baseline in which to monitor progress
True
Psychotherapy can begin before substance abuse treatment in long term substance abuse users.
False, substance abuse treatment needs to happen before psychotherapy.
There are many assessment tools for identifying substance abuse: AUDIT, CAGE-AID, TWEAK, MAST, etc. What should a clinician keep in mind when using these?
The level of education of the patient, language barriers, cultural sensitivity.
True or False: Substance abuse assessments should include: acute intoxication/withdrawl potential, biomedical conditions, emotional/behavioral conditions, treatment acceptance or resistance, relapse or continue use potential, and living environment.
True
This syndrome is caused by thiamine deficiency and causes memory problems which is found under amnesic disorders rather that substance abuse disorders. Symptoms include not being able to form new memories, confabulation, hallucinations, and loss of memory.
Korsakoff’s syndrome
This syndrome is caused by thiamine deficiency and is associated with the chronic abuse of alcohol. Symptoms include confusion, muscle coordination issues (ataxia) and vision issues.
Wernicke’s encephalopathy
Information complied during the personal history, interview, physical exam, and other patient specific assessments are used to make a __________?
diagnosis
Maladaptive pattern of abuse leading to significant impairment in functioning. Substance use continues despite negative consequences and problems with work, relationships, legal issues.
Susbtance abuse
Physiologic tolerance in which increasing amounts of substances are needed to achieve intoxication and prevent withdrawl symptoms. Use continues despite negative consequences and problems with work, relationships, legal issues.
substance dependence
True of False: To make a diagnosis of substance dependence you need evidence of significant impairment in functioning but not necessarily tolerance or withdrawl symptoms.
True.
True or False: After making a diagnosis of substance abuse the next step is to detox and than get the patient to inpatient rehab.
False, it is important to consider the least restrictive setting and make sure the level and type of services that the patient needs matches with the patient.
True or False: The 3 stages of substance abuse treatment is stabilization, rehabilitation, and maintenance.
True
True or False Detox is a designated treatment modality
False
WIthdrawl from this drug includes: “high feeling”, euphoria, hyperactivity, restlessness, anxiety, impaired judgment, dilated pupils, sweating, nausea vomiting, muscle weakness, fast heart rate, increased blood pressure.
Cocaine
This medication produces unpleasant side effects if the patient drinks alcohol
antabuse
Pyschosocial interventions may include these types of therapy.
individual, group, marital, or family therapy
This type of therapy extinguish undesirable behaviors and encourage desired ones. Behavior modification
Behavioral therapies
This treatment uses a biopsychosocial model and uses AA
Minnesota model or residential chemial dependency treatment
this treatment uses counseling and therapeutic techniques, skills training, educaiton supports, and no pharmacotherapy.
drug-free OP tretment
this treatment substitutes legal medications for illegal drugs. I.e. methadone
methadone maintenance/opioid substitution treatment
This treatment is for people with psychosocial adjustment problems and require resociatization in a structured setting. They use behavioral techniques and are long term intensive programs
therapeutic community residential treatment
True or False, recovery is an ongoing process for addiction. And prevention of relapse is a critical par of treatment
True
True or False: Social pressure, interpersonal conflict, and negative emotional states are not risk factors for drug relapse.
False
True or False: Relapse is a process and one must learn to id situations and symptoms of relapse and use cognitive and behavioral techniques to minimize the effects of relapse. Relapse is an opportunity to learn new coping skills.
True, cognitive-behavioral approach focused on social learning theory by Marlatt and Gordon.
It is harder to cope with relapse when one can relate the relapse to external factors
False, It is easier to deal with a relapse if the person attributes the relapse to external factors.
True or False Gorski’s model of relapse prevention is based on disease model of addition and the biopsychosocial approach to treatment.
True
It has 6 stages Transition, stabilization, early recovery, middle recovery, late recovery, and maintenance.
True or False: Gorski- PAW (post acute withdrawl) symptoms include decreased cognitive functioning, memory issues, difficulty regulating emotions, balance and motor coordination problems, difficulty handling stress.
True
True or False: A good predictor of continuing success is the prolonged abstinence following treatment.
True
Definition of detox
Process in which the body frees itself from a drug
Definition of withdrawal
Physical symptoms of detox
definition of dual diagnosis
has 2 diagnosis of both substance abuse and psychiatric disorders
True or False: a patient with dual disorder respond to conventional treatment approaches.
False: Patients with dual diagnosis are less responsive and more resistant to treatment and experience greater levels of denial.
The best treatment of dual diagnosis is ____________?
both mental health and substance abuse treatment; using multimodal, integrated treatment programs.
standard of care for dual diagnosed is to use meds, however alternative treatment options may be used. What are these treatments?
individual psychotherapy, self-help groups, support groups, non-psychoactive drugs
It is difficult to confirm psychiatric illness when substances are used. However, there are a few ways to see the psychiatric illness, name some.
family history, client’s history indicates psych onset prior to substance abuse, the severity of symptoms and problems are more so than those with only substance abuse problems, multiple substance abuse and psych treatment failures, positive response to psych meds.
What are some risk factors for suicide
white, over 65, lack of social support, psychiatric disorder, severe hopelessness, communicates intent and presence of plan
True or False: a person who has been depressed and suddenly becomes brighter may be at higher risk of suicide.
True: they may have decided to commit suicide.
True or False: a patient is not at risk of suicide after being dc’d form hospital or started on antidepressants.
False, they may now have the energy to implement a suicide plan
What is the medical necessity criteria for involuntary commitment?
danger to self, danger to others, and inability to care for self
True or False: Even though they meet hospital criteria for psych hospitalization, managed care can make their own decision and disagree with you.
True. Managed care could disagree.
True or False, accurately assessing violence include factors such as circumstances of the evaluation and length of time over which the prediction is being made.
True. a structured approach using clinical assessment and getting a detailed past history as well as predicting a brief time period is the most accurate.
True or False: A past history of violent behavior is the best predictor of future violence.
True
Static risk factors
past history of violent behavior or demographic info
dynamic risk factors
factors that can be changed by interventions, i.e. living situation, treatment of psychiatric symptoms, access to weapons, etc. Each patient has their own risk factors which requires an individualized violence prevention plan
True or False: one of the most significant factors contributing to the child’s adjustment after abuse is the level of parental support.
True.
if you have reasonable suspicion that a child is being abused or neglected how quickly must a report be made?
Within 36 hours.
can you remain anonymous when reporting abuse?
no, if the report is informed that their information will be held confidentially.
