Behavioral Dynamics Flashcards

1
Q

Psychiatrist characteristics - degree, what they do?

A
  • MD
  • diagnostic evals
  • psychotherapy
  • med management
  • speciality areas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Clinical psychologist - What do they do?

Counseling psychologist?

A
  • PhD or PsyD
  • admin and interpret psych testing
  • development of prevention and tx programs
  • psychotherapy
  • expert testimony
  • counseling psychologist: PhD - counseling, psychotherapy, assessments and consultation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Educational psychologist - what do they do?

A
  • masters in ed. psychology
  • dx and psych assessments
  • counseling
  • mediation, co-ordinates with and refers to other professionals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Licensed clinical professional counselor - training?

A
  • masters training in counseling

- therapists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Psych social worker - training and work?

A
  • masters or doctorate in social work
  • mental health assessments
  • case management
  • group facilitators
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does counseling entail? Therapy?

A
  • counseling: personal guidance, std psych methods - collect case history data, and test for interests and aptitudes
  • therapy: relieving or curing a disability or illness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Psychotherapy - psychodynamic/psychoanalytic?

A
- freudian traditions:
unconscious conflicts
family issues from early life
difficulties with current relationships
- severe and chronic personality disorders
- persistent problems in coping with life events
- few months to a few years
- rarely used today
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Behavioral therapy- entails what, used for?

A
  • reducing sxs by:
    relaxation techniques
    changing factors that reinforce sxs, graduated exposure to distressing stimuli
  • anxiety disorders, depression, psychomatic complaints - OCD, phobias
  • generally brief: 6-12 sessions
  • guided imagery - learning how to relax while imagining feared situation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cognitive thinking (CBT)- what is it used for?

A
  • assumption that negative thoughts promote anxiety or depression
  • pt taught to challenge negative thoughts
  • depression, anxiety, problems related to substance abuse issues
  • 10-20 sessions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is dialectical behavior therapy? used in what?

A
  • CBT and mindfulness (in the here and now)
  • acceptance and change
  • 1st therapy to show positive change in borderline personality disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Use of group therapy?

A
  • support group - cancer, grief
  • education
  • can be open ended, or time-limited
  • any theoretical orientation
  • personality disorders, grief work, physical health issues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sign vs symptom?

A
  • sign: what you see

- sx: is what pt says that they are experiencing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is consciousness? Emotion? motor behavior?

A
  • consciousness: awareness of self and environment, orientation to person, place and time
  • emotion: psychic feeling with physiological response
  • motor behavior: physical agitated (restless); motor slowed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cognitive process of thinking?

A
  • fomring mental images or concepts
  • can be concrete or abstract
  • linear, goal directed vs Tangential/flight of ideas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Perceptions?

A
  • recognition and interpretation of sensory stimuli
  • hallucinations: responding to internal stimuli
  • illusion: perception from an external stimulus, usually auditory (voices on wind)
  • delusion: fixed belief not basd on reality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Definition and components of intelligence?

A
- potential ability and capacity to:
acquire
retain
apply:
understanding
knowledge
reasoning
judgement
17
Q

Diff b/t psych and medical-surgical interview?

A
  • rather than just trying to determine what their sxs are - find out what they are experiencing
  • insight oriented instead of sx oriented
  • psych interview involves:
    obtaining hx, eval mental status, collecting auxillary data, summarizing principle findings, dx, making prognosis, determining tx plan
18
Q

Diff methods of psych interview?

A
  • want to make pt feel comfortable, foster trust, and develop expectation that tx will help
  • reflection: pick up feeling of pt’s message and repeats it back to pt, encourages pt to clarify
  • silence: giving pt time to communicate feelings
  • confrontation: presenting their behaviors and apparent feelings back to them
19
Q

Components of the mental status exam? appearance, behavior, speech, mood, congruency, perception?

A
  • describe:
    behavior
    speech
    emotions
    cognition
    perceptual processes
  • objective report
  • appearance: clothes, posture, grooming, degree of alertness
  • behavior: motor activity - hyper motor/slowed, impulse control, gestures, gait
  • speech: volume, rate, accents, clarity
  • mood: how are they feeling
  • affect: what expressions you observe: lability - go from crying to laughing
    stability: mood stable?
    congruency: is affect congruent with what they are saying
  • perception: hallucinations (hearing, seeing, smelling, feeling things), illusions
20
Q

MSE - thought process, thought content?

A

thought process: continuity - linear and goal directed or flight of ideas/loose associations
- thought content:
word usage -
neologisms: saying things that make no sense at all
approximations: dementia - can’t name a clock but can describe it
content: logical vs illogical (my body conforms to my clothes)

21
Q

MSE - concentration, attention, orientation, memory, judgement?

A
  • concentration: ability to focus
  • attention: ability to sustain focus
  • orientation: person, place, time, situation
  • memory: remote(last to go), recent, immediate
  • judgement - social situations
22
Q

MSE - insight, intelligence?

A
  • insight: complete denial
    dim awareness
    awareness but inappropriate blame
    awareness with knowledge of internal source
  • intelligence: average, below average, above average - what you perceive it to be
23
Q

MMSE - orientation, registration, attention and calculation, recall?

A
  • MMSE: possible to get 30 pts, anything unde 24 - abnormal, avg for dementia is 10
  • orientation - possible 10
  • registration: attention and concentration - spelling backward
  • attention and calculation - serial 7s backwards
  • recall: immed memory: ask for 3 objects told in registration
24
Q

MMSE - language, visual motor integrity, level of consciousness along continuum?

A
  • language: 6 steps - understangin, following instructions - write a sentence, folllow commands
  • visual motor integrity: copy design of intersecting shapes
  • level of consciousness along a continuum
25
SLUMS intrument?
``` - dementia: orientation executive fxning - making change memory - repeat list language - name animals calculation visuoconstructive skills: draw clock ```
26
MOCA?
- Montreal cognitive assessment - rapid screening for mild cog impairment - over 26 is normal (out of 30): attention and concentration executive fxning memory language calculations orientation visuoconstructive skills
27
Zung self-rating depression scale?
- pt fills it out | - avg score for depression 50-69, over 69 is severe depression
28
Hamilton rating scale for depression?
- rating severity and progress or lack of progress, performed by health professional (psychiatric) 21 ?s - score first 17 ?s - use when pt is already dx with depression - 0-7 WNL - 8-19 mild depression - over 20 moderate to severe
29
Beck anxiety inventory?
- pt fills this out - 0-7 WNL - 8-15 mild - 16-25 mod - 26-63 severe
30
Mood disorder questionnaire is used when?
- used in bipolar disorder - answer yes to 7 or more items in question 1 - yes to 2 and 3 - positive for bipolar
31
DSM I?
- 1952 - diagnoses were loosely defined - psych etiologies - depressive reaction, paranoid rxns
32
DSM II?
- 1968 - conformity to WHO international classification of disease - diagnostic criteria vague and open to bias - african americans
33
DSM III? multiaxial diagnoses?
- 1985 explicit, readily verifiable and specific diagnostic criteria - multiaxial system of diagnoses - diff classes of meds developed and correct diagnoses were needed to choose appropriate meds - multiaxial diagnoses: axis 1: chief psychiatric diagnoses axis 2: personality disorders, intellectual disabilities axis 3: medical axis 4: social issues axis 5: global assessment of fxning
34
DSM IV?
- 1994 - scientific evidence determined diagnostic categories - descriptive approach - clearly delineated, objective, verifiable criteria - pts don't have identical clinical characteristics updated- IV-TR in 2000
35
DSM V?
- 2013 - ICD 10 - developmental and lifespan considerations: begins with early life through later life - gender differences: express diff - diagnoses: ex - autism spectrum disorder - enhanced specificity: major and mild neurocog. disorders that were previously lumped under dementia - section III - new disorders requiring further study - online enhancements available
36
Psych charting components - progress note?
``` progress note: - Hx of current illness: reason for admission - current status - suicidal ideation? response to tx - MSE - medical status - plan ```
37
Admit note (or H&P)?
- Identifying info (age, appearance) - HPI: suicidality? - psych hx: previous diagnoses hospitalizations professionals meds - substance abuse hx - past medical hx (any self harm?) - family hx - good response to med? - developmental/social hx: family life: relationships, marital status education occupation housing physical, mental, emotional abuse - MSE - plan: testing - labs, xrays, CT scans, MRI, neuro eval, referrals, meds, therapy
38
Everything that is included in the MSE - goes in note?
- appearance - mood - orientation - intellect - thought processes - speech - perceptions - judgement - insight