Chpt 14 - Mental Disorders

Question 1

Name 6 contributing factors to mental disorders.

Answer 1

• Stress
• Trauma
• Hereditary
• Chemical imbalance
• Socioeconomic
• Psychosocial (effect of social circumstances on own thoughts e.g. social media & friends)

Question 2

List some of the many causes of mental retardation.

Answer 2

Predisposing factors:

• heredity i.e. genetic disorders / chromosomal disorders
• alterations to embryonic development via toxins
• hypoxia & viral infections (pre-/peri-/postnatal)
• general medical conditions (infections/trauma/poison)
• environmental influences (again toxins or lack of nutrients e.g. FAS)

Question 3

Describe the characteristic manifestations of pervasive development disorders (PDDs), including autism and name 2 more syndromes.

Answer 3

Severe impairments in several areas of development e.g.
1 - Communication
2 - Social interaction skills
3 - Lack of non-verbal communication
4 - Lack of reciprocation of emotions
5 - some time also motor & language skills
6 - Inappropriate responses in conversation
Examples: Autism, Rett- & Asperger syndrome.

Question 4

List 7 criteria for diagnosis of attention-deficit / hyperactivity disorder (ADHD).

Answer 4

Children: must have at least 6 symptoms* from
either (or both) the inattention group of criteria and
the hyperactivity and impulsivity criteria
Older adolescents and adults (over age 17 years) must present with 5.
1) An inability to sit quietly (seated) without fidgeting or squirming.
2) Inappropriate running and climbing, difficulty in playing, and excessive talking.
3) Difficulty in sustaining attention and completing tasks. 4) Careless / messy work, failure to give close attention to details.
5) Avoids activities that require sustained attention, effort, concentration, and organization.
6) A display of impatience, difficulty in waiting for one’s turn, frequent interruptions, and failure to listen to directions are manifestations of impulsivity.
7) The inability to organize activities and define goals creates difficulty in performing simple tasks, such as picking up toys.

Question 5

List some examples of tic disorders.

Answer 5

Tic disorders may be motor or vocal and may be chronic.

1) Simple motor tics = eye blinking, facial grimacing, coughing, and neck jerking.
2) Complex motor tics = making facial gestures, jumping, touching, and stamping.
3) Simple vocal tics = throat clearing, sniffing, snorting, and grunting.
4) Complex vocal tics = the repetition of words out of context, the use of socially unacceptable words, and the repetition of one’s own words.

Question 6

Describe the progressive degenerative changes in an individual with Alzheimer disease.

Answer 6

Mental / physical / intellectual functioning.

1) Alzheimer disease is a progressive degenerative disease of the brain that produces a typical profile of lost mental and physical functioning.
2) It is the most common cause of deterioration in intellectual capacity, or dementia.
3) It is most common in people older than 65, and its incidence increases in people older than 80.

Question 7

Explain important factors in the treatment of Alzheimer disease.

Answer 7

• No cure is known for Alzheimer disease
• Treatment is supportive and is geared toward helping alleviate symptoms
• Drug therapy to help alleviate cognitive symptoms includes the use of cholinesterase inhibitors, with the primary drug being donepezil (Aricept).

Question 8

Explain the cause of vascular dementia.

Answer 8

1) A reduction in blood flow to the brain can result from narrowed and stenosed arteries (see plaque).
2) The resulting hypoxia and reduced nourishment to the brain cells cause a general loss in intellectual abilities.
3) Causes:
a) As atherosclerotic plaque grows in the carotid and cerebral arteries, blood flow to brain tissue is reduced.
b) Prolonged hypoxia with resulting ischemia leads to irreversible necrosis and death of the brain cells.
c) When an embolism causes the blockage, the hypoxia is sudden and complete.
d) Small aneurysms may be responsible for minute cerebral bleeds.

Question 9

Relate treatment options for alcohol abuse.

Answer 9

Def: Alcohol abuse or alcoholism is a disorder of physical and psychological dependence on daily or regular excessive intake of alcoholic beverages.

1. Rehabilitation: a specialized treatment plan that meets the patient’s physical and psychological needs + supports abstinence from alcohol.
2. Detoxification: Followed by psychotherapy or group therapy and participation in the 12-step program of Alcoholics Anonymous (AA).
3. Ongoing therapy: usually can continue on an outpatient basis.
4. Recovery program: Willing participation in a recovery program on a sustained, as-needed basis usually offers a promising prognosis.

Question 10

Name the classic signs and symptoms of schizophrenia.

Explain what is included in the multidimensional treatment plan.

Answer 10

Mental disorder characterized by the presence of either
a) positive manifestations (an excess or distortion of normal functions) or,
b) negative manifestations (a loss of normal functions).
Other:
- Difficulty finishing education, maintain employment, relationships
- Prodromal signs: withdrawal, odd behavior, loss of interest
- Disorganized thinking
- Hallucinations are a common characteristic
- Inappropriate affect (feeling)
- Behavior may be bizarre or grossly disorganized,
unpredictable, agitated, or violent.
—-
Subsequent long-term multidimensional treatment combines supportive psychotherapy, drugs, and family involvement.

Question 11

Explain why bipolar disorder is considered a major affective disorder.
Describe the treatment approach.

Answer 11

Bipolar disorder is a major affective disorder with abnormally intense mood swings from a hyperactive, or manic, state to a depressive syndrome.
> Major effective = substantial impairment over a distinct period of time; The patient may remain manic for days, weeks, or months before experiencing depression.
—
- After diagnosis, therapeutic treatment is dictated by the specific form of behavior the patient exhibits.
- Lithium carbonate is the drug of choice during an acute manic phase of bipolar disease.
- During an episode of depression, antidepressants are used with caution because they may trigger a manic episode. Antidepressants are best used in conjunction with anticonvulsants for optimal mood stabilization
- Treatment includes a therapeutic milieu, or environment, that meets the patient’s physical needs, encourages personal responsibility, and sets reasonable limits and goals for behavior. During this time, the patient may need to be protected from self-injury.

Question 12

Discuss normal grieving process phases.

Answer 12

1. Denial: “No, I don’t believe it.”
2. Anger: “Why did he or she do this to me?” or “Why is God letting this happen?”
3. Bargaining: “If only this task can be accomplished or I can achieve this goal (live long enough), I will do this.”
4. Depression: in which people retreat within themselves and have little or no involvement with their environment.
5. Acceptance.

Question 13

Discuss how each type of anxiety disorder prevents a person from leading a normal life (previously known as neuroses).

Answer 13

Only when anxiety persists and prevents the person from leading a normal life does it become an illness.
a) Generalized AD / Panic disorder:
Their constant worrying often is accompanied by physiologic symptoms, such as diarrhea, elevated blood pressure, and sustained muscular tension. Inability to sleep and nightmares are common. Some patients are even prone to panic attacks.
b) Phobic Disorder:
Irrational fear and the avoidance of the phobic stimulus. Phobic people must design their lives to avoid the things that they fear.
c) OCD:
Marked by the presence of obsessions (persistent unwanted thoughts) and compulsions (persistent urges to carry out specific actions). These people feel as though they have lost control of their minds, which causes them great anxiety. People with compulsions develop senseless actions or rituals that relieve their anxiety temporarily (e.g., excessive hand washing)
d) PTSD:
PTSD is a delayed response to an external traumatic event that produces signs and symptoms of extreme distress. People with PTSD go out of their way to avoid being reminded of the painful event. These individuals also may exhibit strong physiologic responses to any reminder of the event.

Question 14

Explain how posttraumatic stress disorder (PTSD) differs from other anxiety disorders.

Answer 14

a) PTSDs are different from other anxiety disorders, because the cause of the stress is an external event of an overwhelmingly painful nature (i.e. real and any “normal” person can get it).
b) The likelihood of developing PTSD appears to depend, to some degree, on the person’s psychological strength before the event.

Question 15

Explain how a somatization disorder is diagnosed (diagnostic criteria).

Answer 15

Somatization disorder is also known as Briquet syndrome. This disorder is multisymptomatic, occurring before the age of 30.
The diagnosis is made after medical conditions are ruled out.
Criteria include the presence of four pain symptoms, two GI symptoms, one sexual symptom, and one pseudoneurologic symptom.

Question 16

Discuss the relationship between anxiety and conversion disorder.

Answer 16

Google: Conversion disorder is a mental condition in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained by medical evaluation.

Symptoms include deficits in voluntary motor or sensory functions (paralysis) that are unintentional and preceded by conflicts or other stressors.
Clinically significant social and occupational functioning is present.
- Sensory symptoms may include anesthesia, hyperesthesia, analgesia, and paresthesia.
- Motor symptoms may include paralysis, tremors, tics, contractures, and ambulation disturbances.
- Speech disturbances may include aphonia and mutism, and visceral symptoms may include headaches, difficulty in swallowing and breathing, choking, coughing, nausea, vomiting, belching, cold and clammy extremities, weight loss, and pseudocyesis.
- Blindness and seizures also may be noted.

Question 17

Describe Munchausen syndrome.

Answer 17

Patients with Munchausen syndrome know that they are not ill but seek medical attention so that they can draw attention to themselves.
They feign symptoms and actually can make themselves ill by injecting foreign material to cause a fever.
These patients generally have extensive knowledge of medical terminology and hospital routines.

Question 18

Contrast insomnia to narcolepsy.

Answer 18

The individual experiencing insomnia has difficulty in
falling asleep and/or staying asleep.
Narcolepsy, irresistible daytime sleep episodes, can
have duration of a few seconds to a half hour.

Question 19

List and discuss personality disorders, including the distinguishing characteristics.

Answer 19

A personality disorder is a pattern of behavior that deviates from society’s norms. In addition, a person with a personality disorder typically has thoughts about the self and the world that cause inappropriate behavior. There are 10 named personality disorders, categorized into three clusters.

1) Antisocial Disorder
- Cause frequent conflicts with societal values.
2) Cluster A
- Paranoid Personality Disorder
- Schizoid Personality Disorder
- Schizotypal Personality Disorder
2) Cluster B
- Antisocial Personality Disorder
- Borderline Personality Disorder
- Histrionic Disorder
- Narcissistic Disorder
3) Cluster C
- Avoidant Personality Disorder
- Dependent Personality Disorder
- Obsessive Compulsive Personality Disorder

Question 20

Key Terms
affect (AF-feckt)
amyloid (AM-ih-loyd)
anhedonia (an-hee-DOH-nee-ah)
autism (AW-tism)
catatonic (kat-ah-TOH-nic)
circadian (sir-KAY-dee-an)
cognitive (KOG-nih-tive)
deficit (DEAF-ih-sit)
delusion (dee-LOO-zhun)
endarterectomy (end-ar-ter-EK-toh-me)
hallucination (ha-loo-sih-NAY-shun)
hypoxia (hi-POX-ee-ah)
ischemia (is-KEY-me-ah)
mutism (MYOO-tizm)
narcissistic (nar-sis-SIST-ik)
paranoid (PAR-ah-noid)
psychotic (sigh-KOT-ik)
schizoid (SKIZ-oyd)

Answer 20

Various

Question 21

Define the following terms:

• anesthesia
• hyperesthesia
• analgesia
• paresthesia

Answer 21

Anesthesia - Anesthesia or anaesthesia is a state of controlled, temporary loss of sensation or awareness.
Hyperesthesia - excessive physical sensitivity, especially of the skin.
Analgesia - the inability to feel pain.
Paresthesia - n abnormal sensation, typically tingling or pricking (‘pins and needles’), caused chiefly by pressure on or damage to peripheral nerves.