Exam 1 Flashcards
What is mental health?
A state of wellbeing in which individuals:
- Reach their own potential
- Cope with normal stresses of life
- Work productively
- Contribute to the community
What are traits of people with good mental health?
People who have the capacity for:
- Rational thinking
- Communication skills
- Learning
- Emotional growth
- Resilience
- Self-esteem
What is the most important key for mental health?
Resilience
Self-esteem is important too
What is another name for mental illness?
Mental disorder
What is a mental illness defined as?
All psychiatric disorders that have a definable diagnoses
What are mental illnesses related to?
Developmental, biological, or psychological disturbances in mental functioning
An example of a mental illness where the ability to think being impaired
Altzheimer’s
An example of a mental illness where emotions are affected
Major depressive disorders
An example of a mental illness where behavioral alterations are apparent
Schizophrenia
Explain the mental health continuum
At one end: Health/well being
In the middle: emotional problems or concerns
At the other end: mental illness
Define resilience*
*Ability and capacity to secure resources needed to support well-being
(The single biggest protective factor for mental health)
What is resilience characterized by?
Ability to secure needed resources
Capacity for regulating one’s own emotions and overcoming negative, self-defeating thoughts
Which individual attribute or behavior is essential for recovery?
Resilience
Examples of risk and protective factors involving social and economic circumstances
Family
Schools and peer groups
Socioeconomic status
Educational advancement
Risk and protective factors involving environmental factors
Political climate and cultural considerations
Social and economic policies
(Marginalized populations = risk factor)
Why is mental illness a physical illness?
The root of most mental disorders lies in intercellular abnormalities
Define the diathesis-stress model?
Diathesis: biological predisposition
Stress: environmental stress/trauma
(Nature vs. Nurture)
Explain what the diathesis-stress model is
The most accepted explanation for mental illness
The combination of genetic vulnerability and negative environmental stressors cause mental illness
Define parity
Equivalence
What was the Mental Health Parity Act (1996)?
Required insurance companies to provide equal treatment coverage for psychiatric disorders (but did not require them to cover it)
(But many insurance companies still place limits on mental health coverage)
What was the Patient Protection and Affordable Care Act?
- Provides coverage for most uninsured Americans through expanded Medicaid eligibility (for very poor)
- Created health insurance exchanges to offer more choices
- “Insurance mandate” for coverage
Define epidemiology
The quantitative study of the distribution of mental disorders in human populations
(to identify high-risk groups and high-risk factors)
Define incidence
Number of new cases in a given time
Define prevalence
Number of cases regardless of when they began
Define lifetime risk
Risk that one will develop a disease during a lifetime
Does the flu have a higher incidence or prevalence?
Higher incidence
Because we don’t get the flu and keep the flu
Does diabetes have a higher incidence or prevalence?
Prevalence because once you are diagnosed with it, you always have it
How are mental disorders diagnosed?
- Use official medical guidelines of the American Psychiatric Association for diagnosing psychiatric disorders
- Based on specific criteria influenced by multi professional clinical field trials
How are mental disorders classified?
Using clinical descriptions of mental and behavior disorders which have two broad classifications and subclassifications
What is evidence based practice in psychiatric mental health nursing?
Use nursing, psychosocial, neurobiological theories, and research
How does psychiatric mental health nursing promote mental health?
Through assessment, diagnosis, and treatment of behavioral and mental disorders
Most important trend affecting the future
Advocacy
In what ways does a psychiatric nurse advocate for their patients?
- Through direct and indirect care, nurses must:
- report abuse, neglect,
- uphold confidentiality,
- support the patient’s right to make decisions regarding treatment
What are trends that will affect the future of mental health?
Educational challenges Demand for mental health professionals Aging population Cultural diversity Science, technology, and electronic healthcare Advocacy Legislative involvement
Levels of Awareness in Freud’s psychoanalytic theory
Conscious
Preconscious
Unconscious
Define conscious according to Freud
Contains all the material a person is aware of at any one time
Define preconscious according to Freud
Contains material that can be retrieved rather easily through conscious effort
Define unconscious according to Freud
Includes all repressed memories, passions, and unacceptable urges lying deep below the surface
The three distinct systems of the personality according to Freud’s theory
Id
Ego
Superego
What is id?
Totally unconscious and impulsive
Drives instincts and reflexes
What is the ego?
Problem solver and reality tester
Attempts to navigate the outside world
What is the superego?
Moral component of personality
Induces guilt and pride
What is classical psychoanalysis?
Freud’s premise that early intra psychic conflict is the cause for all mental illness
This theory is no longer thought to be valid
Define *transference
Unconscious feeling that the patient has toward you that was originally felt during childhood
EX: an older patient says “you remind me so much of my granddaughter”
Define *countertransference
*this is what we (as the nurse) feel toward the patient. This comes into play with how we treat patients (justice and fairness)
What is the psychodynamic theory?
- Newer psychoanalytic model that focuses more on here and now
- Uses tools of psychoanalysis
- Best candidates are the “worried well”
- Increased back and forth between therapist and patient
Define *interpersonal theory
The purpose of all behavior is to get needs met through interpersonal interactions and to reduce or avoid anxiety
Define anxiety according to Sullivan
Any painful feeling or emotion that arises from social insecurity or prevents biological needs from being satisfied
Define security operations according to Sullivan
Measures the individual uses to reduce anxiety and enhance security
Define self-system according to Sullivan
All of the security operations an individual uses to defend against anxiety and ensure self-esteem collectively make up the self-system
What is interpersonal therapy most effective in treating?
Grief and loss
Interpersonal disputes (relationship conflicts)
Role transition
Who established the foundations for interpersonal theory implications for nursing?
Hildegard Peplau
How did Peplau apply the Interpersonal Theory to nursing?
- Nurses are both participants and observers in therapeutic conversations
- Self-awareness helps keep focus on patient
- Lowering patients’ anxiety improves ability to think and function
What are behavioral theories?
Use conditioning to respond to a specific stimuli
How are behavioral theories applied to nursing?
Modifying or replacing behaviors
Behavior management
What is behavioral therapy?
Assumes that changes in maladaptive behavior can occur without insight into the underlying cause
What is behavioral therapy best used to treat?
Phobias
Alcohol use disorder
Schizophrenia
And many other conditions
5 types of behavioral therapy
Modeling Operant conditioning Exposure therapy Aversion therapy Biofeedback
What is modeling behavioral therapy?
The therapist provides a role model for specific identified behaviors
What is operant conditioning behavioral therapy?
Basis for behavior modification
What is exposure therapy behavioral therapy?
Patients are encourages to face their fears to eliminate them
What is aversion therapy behavioral therapy?
Pairs a target behavior with a negative stimulus to extinguish the undesirable behavior
What is biofeedback behavioral therapy?
Used to control the body’s physiological response to stress and anxiety (like relaxing certain muscles) to reduce/eliminate pain
What do cognitive theorists believe?
- There is a dynamic interplay between individuals and the environment
- *thoughts come before feelings and actions
- Thoughts about the world and our place in it are based on our own unique perspectives, which may or may not be based on reality
Two of the most influential cognitive theories:
Rational-emotive behavior therapy
Cognitive-behavioral therapy
How does rational-emotive behavior therapy work?
Aims to eradicate irrational beliefs by helping patients recognize thoughts that are not accurate
How does cognitive-behavioral therapy work?
Teaches pts to challenge distorted beliefs and change their way of thinking
In order to reduce symptoms of depression and anxiety
Which group does trauma-focused cognitive behavioral therapy focus on?
First developed to address sexual abuse trauma in children
Expanded for all ages
Still focuses more on children and adolescents
How does trauma-focused cognitive behavioral therapy work?
For trauma that is very difficult to get past,
Is short-term, and incoorporates cargivers and family therapy
Helps identify feelings and how to manage them (and replace negative thoughts)
What are dialectical strategies?
Integration of opposites (help the patient and therapist give up extreme positions)
Which type of patients was dialectical behavioral therapy developed for?
Individuals with intractable behavioral disorders involving emotional dysregulation (ex: women with borderline personality disorder)
How does dialectical behavioral therapy work?
Employs CBT elements:
- mindfulness
- distress tolerance
- interpersonal effectiveness
- emotional regulation
What is CBT mindfulness?
Being aware and present in the moment
What is CBT distress tolerance?
Tolerating pain instead of frantically trying to transform it
What is CBT interpersonal effectiveness?
Asking for what you want and being able to say no when needed
What is CBT emotional regulation?
Choosing and changing emotions that are problematic
What are implications for nursing regarding cognitive theories?
Recognizing the interplay between events, negative thinking and negative responses
Helping the patient identify negative thought patterns
What do humanistic theories focus on?
Human potential and free will to choose life patterns supportive of personal growth
Emphasize a person’s capacity for self-actualization