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Psychiatry > CBT and ECT > Flashcards

CBT and ECT Flashcards

1
Q

Define arbitary inference

A

Specific conclusion without supporting evidence/ despite contrary evidence

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2
Q

Name 5 limitations or careful considerations to the use of electroconvulsive eterapy

A
  1. Cerebral aneurysm
  2. Raised icp
  3. Recent mi
  4. Cardiac arrhythmia
  5. High anaesthetic risk
  6. Neurological conditions/ skull fractures
  7. Brain tumour
    (no absolute contraindications)
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3
Q

What is the gold standard of electrode placement in ect?

A

Bilateral/bitemporal

Other placements: r unilateral, bifrontal

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4
Q

What is a therapeutic dose of ect?

A

Seizure 15-70s on eeg recording

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5
Q

What is the maximum time period for a seizure in ect?

A

2 minutes or more- promptly stop!

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6
Q

Name 6 adverse effects ect

A
  1. Death due to cardiopulmonary event : very rare
  2. Aspiration pneumonia
  3. Headaches
  4. Dental and tongue injuries
  5. Transient nausea
  6. Cognitive: acute confusion, retrograde and anterograde amnesia . Short term
  7. Epilepsy
    8 anaesthetic events
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7
Q

What is the cognitive theory?

A

THOUGHTS are the primary determinants of EMOTIONS/FEELINGS and BEHAVIOUR, which in turn influences thoughts (“triad”)

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8
Q

Define intermediate core beliefs

A

How people derive the meaning of experience, develop over time

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9
Q

Define selective abstraction

A

Cognitive distortion in which Detail is taken out of context eg his arms are crossed, therefore he must be mad at me

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10
Q

Abstracting a general rule from a single or few isolated incidents refers to which cognitive distortion?

A

Overgeneralisation

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11
Q

Reaching a specific conclusion without supporting evidence or despite contradicting evidence refers to which cognitive distortion?

A

Arbitrary inference

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12
Q

Detail out of context refers to which cognitive distortion?

A

Selective abstraction

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13
Q

Focusing heavily on something or giving it great importance refers to which cognitive distortion?

A

Magnification

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14
Q

Overlooking or disregarding or not seeing something as important refers to which cognitive distortion?

A

Minimisation

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15
Q

Attributing events to oneself without evidence supporting causal connection refers to which cognitive distortion?

A

Personalisation

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16
Q

Categorising experience in one of 2 extremes refers to which cognitive distortion?

A

Dichotomous thinking

Eg those who are not for us are against us

17
Q

Name the 5 principles of behaviour therapy

A
  1. Classic conditioning
  2. operant conditioning
  3. Positive reinforcement
  4. Negative reinforcement
  5. Punishment
  6. Extinction
18
Q

Define classic conditioning

A

Associating an involuntary response and a stimulus

19
Q

Define operant conditioning

A

Associating a voluntary behaviour and a consequence. Rewarded with incentives

20
Q

Define extinction as a cognitive behaviour technique

A

Decrease behaviour following removal of responses

21
Q

Name indications electroconvulsive therapy

A

DESPOND MBCHB

  • depression: major episode, with melancholic features - if treatment resistant
  • epilepsy (status)
  • schizophrenia treatment resistant
  • Parkinson’s
  • OCD
  • NMS last resort
  • delirium severe
  • mania: severe symptoms eg agitation/exhaustion / delirium, poor response, med intolerance
  • bipolar treatment resistant
  • Catatonia
  • history of good response
  • bad side effects to meds
22
Q

Which medications must be stopped before ECT

A
  • Anticonvulsant
  • lithium (increase seizure duration, postictal confusion/ delirium
  • theophylline (status risk)
  • antidepressants (lower seizure threshold, TCA worsen cardiac irritability)
23
Q

Name 6 cognitive distortions

A
  • Arbitrary inference
  • selective abstraction: detail taken out of context
  • overgeneralisation
  • magnification + minimisation
  • personalisation
  • dichotomous thinking: extremes eg those not for us are against us
24
Q

Name 3 cognitive strategies in CBT

A
  • Collaborative empiricism: dr + pt are co-investigators
  • Socratic dialogue: promote new learning by asking probing questions
  • guided discovery: behavioural / thought experiments

Psychiatry (31 decks)

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