Chapter 10: Psychiatric & Cognition Flashcards
Stereotypy
Repetition of fixed patterns of movement and speech (echolalia)
Akathisia
State of restlessness characterized by urgent need for movement, usually side effect of meds
Circumstantiality
Speech that is delayed in reaching the point and contains excessive or irrelevant details
Tangentiality
Abrupt changing of focus to a loosely associated topic
Flight of Ideas
rapid shifts in thoughts from one to another
Thought blocking
interruption of a thought process before it is finished
Loosening of Association
disorder of the logical progression of thoughts where seemingly unrelated and unconnected ideas shift from one to another
Nominal aphasia
Inability to name objects
Illusions
misperceptions or mininterpretations of real sensory events
Agnosia
Inability to understand and interpret the significance of sensory input
Recent memory
Recall events within the past few days
Recent past memory
Recall events of the past few months
Remote memory
Recall events of the distant past, aka long-term memory
Procedural Memory
Automatic sequence of behavior such as conditioned responses
Declarative Memory
Consciously learned facts, such as school subjects
Semantic Memory
Knowing the meaning of words and the ability to classify information. Includes things that are common knowledge, such as the names of colors, the sounds of letters, the capitals of countries and other basic facts acquired over a lifetime.
Episodic Memory
Knowledge of one’s personal experiences
Prospective Memory
Remembering to carry out future actions.
DSM-IV Axis I
Clinical disorders
Axis II
Personality disorders & “mental retardation”
Axis III
General medical conditions
Axis IV
Psychosocial & environmental problems
Axis V
Global assessment of functioning on a continuum between 0-100.
Bipolar I disorder
one or more manic episode, may be combined with depressive episodes
Bipolar II disorder
no manic episodes, at least one hypomanic episode (less severe mania), one or more major depressive episodes
Schizoid Personality Disorder
lifelong patter of social withdrawal, introvert, constricted affect, eccentric, isolated, loney
Schizotypal Personality Disorder
odd, strange in thinking and behavior, magical thinking, peculiar ideas, illusions (false perception of real external stimulus), derealization
Borderline Personality Disorder
unstable affect, mood, behavior, relationships and self image. Fear of abandonment, frantic efforts to avoid it. Self-destruction and harm. Usually history of trauma.
Reisburg’s Stage 1 of Dementia
No disability is noted
Reisburg’s Stage 2 of Dementia
Forgets normal age-related info (lost keys..)
Reisburg’s Stage 3 of Dementia
Strengths: Still independent in IADLs, can use compensation and adaptations. Weaknesses: Forgets important info for the first time in their life, difficulty with complex tasks, difficulty with directions to new places
Reisburg’s Stage 4 of Dementia
Strengths: performs routine ADLs, live at home with support, can follow simple verbal cues. Weaknesses: Deficits noted in IADLS. unable to follow written cues, unable to perform familiar but challenging tasks, word finding, needs assist at home now
Reisburg’s Stage 5 of Dementia
Person cannot function independently. Strengths: can perform some ADL/IADL with correct cues and assist, responds to encouragement, Weaknesses: poor judgement, decision making, forgets hygiene, cannot drive
Reisburg’s Stage 6 of Dementia
Cannot perform ADLs without cues. Strengths: can perform components of familiar tasks, can follow hand-over-hand and demonstration. Weaknesses: deficits with 2 step commands, can’t sequence ADLs, can’t speak full sentences, incontinent of bowel and bladder
Reisburg’s Stage 7 of Dementia
Bedbound, unable to respond in any way to questions or commands.
Oppositional Defiant Disorder
Negative, hostile, defiant, temper, argues, actively defies adults, result in functional impairment. ADHD often occurs with ODD.
Conduct Disorder
disregard for others, aggression towards people and animals, destructive, lie, steal, violate rules
Schizophreniform Disorder
Meets criteria for schizophrenia but the episode is more than 1 months but less than 6 (lasting 6 months is required for schizophrenia diagnosis)
Schizoaffective Disorder
major depressive episode, manic episode, or a mixed episode concurrent with symptoms of schizophrenia
Schizophrenia Diagnostic Criteria
Criterion A: presence of two or more: delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, negative symptoms (restricted emotion, lack of pleasure, alogia, anergia) Criterion B: disturbances or function. Criterion C: symptoms for at least 6 months and at least 1 month of criterion A symptoms.
Avoidant Personality Disorder
extreme sensitivity to rejection, socially withdrawn, have desire for companionship but consider themselves unworthy, inferiority complex
Histrionic Personality Disorder
dramatic, extrovert, flamboyant, unable to maintain deep attachments
Antisocial Personality Disorder
antisocial or criminal acts, inability to conform to social norms, lack remorse, no regard for others, conduct disorder can be a precursor
Dysthymic Disorder
Major depressive symptoms that are less severe and present for at least 2 years.
Behavior Modification Theory
Based on operant conditioning. Behavior is shaped by connecting a positive or negative reinforcement. Rewards shape behavior more effectively than punishment. Controversial for adults because it doesn’t require the client to cognitively process.
Intentional Relationship Model
Therapeutic use of self, triad between client, OT, and occupation. “keep head before heart” “mindful empathy”. Balance focus of activities with interpersonal.
Treatment for Oppositional Defiant Disorder
consistent expectations and behavior program, positive reinforcement, clear instructions, time-in/time-out.respond best to moderate, but not too much, structure
Which model emphasizes the notion that healing must come from a safe cultural context?
KAWA!
Cyclothymia
Episodes of hypomania and depressed mood over at least 2 years.
Treatment for Oppositional Defiant Disorder
consistent expectations and behavior program, positive reinforcement, clear instructions, time-in/time-out. ADHD often occurs with ODD.
Treatment for dissociative personality disorder
opportunities for safe and supportive exploration of new personalities. Clients with multiple personality disorder will tend to show more severe symptoms when provided with more opportunities to self-express, such as in nondirective cathartic and verbal groups.
Frontotemporal dementia
Immediate, distinct onset. behavioral changes with an increase in disinhibited behavior, decreased social tact, lack of empathy, and lack of interest.
Vascular Dementia
Cognitive decline similar to AD but less severe memory involvement. Gail disturbances, abrupt or stepwise decline.
Lewy Body Dementia
Deficits in attention, executive function, memory, fluctuating cog, visual hallucinations, parkinsonism, visuospatial.
The recommended method of communicating with a client with Alzheimer’s
Provide as brief and accurate a response as possible without overchallenging the client. Addressing the emotional rather than the factual components of the request, when appropriate, is also recommended.
