Exam 1 Flashcards
1
Q
what is the difference between poor mental health and mental illness
A
poor mental health = loss of psychological well being
mental illness = clincially recognized disorder
2
Q
what are the 5 categories of adult mental illnesses
A
mood disorders
delusional disorders
anxiety disorders
personality disorders
substance related disorders
3
Q
when should promotion and prevention strategies be implemented in order to be maximally effective
A
early, before the onset of mental disorder
4
Q
what are the 3 categories of primary prevention
A
universal - general public
Selective - individuals or groups with increased risk
Indicated - people at high risk
5
Q
what is secondary prevention
A
interventions to reduce prevelance
6
Q
what is tertiary prevention
A
interventions to reduce disability, all forms of rehad, prevention of relapse
7
Q
mental health promotion should enhance what 3 factors
A
social inclusion
freedom from discrimination and violence
access to economic resources
8
Q
what is sense of coherence
A
the extent which one has a feeling of confidence that they will be able to deal with stress, that their environment is manageable, and that stress is a challenge to overcome
9
Q
what is a health assest
A
any factor or resource that enhances ability to maintain health and well being
10
Q
what level of risk (normal, mild-moderate, or high) would the following be:
1. history of assault
2. physical chronic disease
3.poor coping skills
4. risk taking or antisocial behavior
5.poverty
6.poor coping skills
A
1 - mild/moderate
2 - mild/moderate
3 - high
4 - high
5. mild/moderate
6. high
11
Q
What are the 3 levels of contributing factors to mental health
A
individual
social circumstances
environmental factors
12
Q
what is the single most important predictor for cognitive decline and dementia
A
older age
13
Q
what is the recovery model
A
focuses on lived experiences, choices, self management and shared decision making
14
Q
what mental illness’s increase risk for DM
A
depression and schizophrenia
15
Q
what mental health condition increases risk for heart disease and stroke
A
depression
15
Q
what mental illness is associated with increased rates of cancer
A
schizophrenia
16
Q
true or false: people with arthritis have higher rates of serious mental illness
A
false, there are lower states of people with arthritis and serious mental illness although it is unclear if this is true or just lack of reporting
17
Q
true or false: people with mental illness are less likely to be regularly screened for manageable chronic conditions
A
true
18
Q
you can identify risk factors for mental illness but are unlikely to see any signs or symptoms before the age of ____
A
3-4 years old
19
Q
what are the 2 categories of behavioral problems
A
ADHD
Conduct disorder
20
Q
at what age do symptoms typically start to occur in ADHD
A
5-6 years old
21
Q
true of false: over half of children with ADHD will continue to have the disorder in adulthood
A
true
22
Q
preschoolers with high levels of noncomplience and aggression at age 4 are at increased risk for what condition
A
conduct disorder
23
Q
why must prevention and intervention for conduct disorder occur very early in life
A
because intervention must occur before the disorder fully emerges and it is very difficult to treat
24
what childhood mental illness is defined by repetitive and persistent patterns of behavior in which the basic rights of others or the major age apporpriate society norms or rules are violated
conduct disorder
25
what are internalizing disorders
depression and anxiety
26
most mental disorders have their peak occurence at what age
adolescence and young adults
27
what is the most common mental illness in adolescence
anxiety
28
what chronic illness has one of the strongest connects with childhood mental illness
heart disease
29
what specific types of traumatic events in childhood increase risk for early onset psychosis
traumatic events related to an intent to harm like bullying or abuse
30
true or false: early psychotic symptoms in children does not increase risk for schizophrenia as adult
false
31
children showing signs of psychosis should also be screened for what
maltreatment
32
child abuse is associated with obesity in: childhood, adulthood, or both
adulthood
33
Should all clients be screened for history of childhood abuse or trauma?
no, there is no evidence for this
34
what mental illness's begin in adolescence and early adulthood
anxiety and depressive disorders, personality disorders, bipolar disorders
35
what effect does cannabis have on risk for schizophrenia?
if already at risk for schizophrenia, heavy cannabis use double the risk
36
what disorders tend to peak in adulthood
bipolar and personality disorders
37
what is the most common addiction in adulthood
nicotine
38
what are the key risk factors for poor mental health in the elderly
lonliness and isolation
39
if an elderly person presents with new depression, what should you also screen for
dementia as depression may be an early indication of dementia
40
what are the dimensions of trauma
magnitude, complexity, frequency duration, internal or external source
41
what is developmental trauma
early exposure to repetitive trauma
42
what is dysregulation and what is it associated with
associated with trauma
difficulty controlling emotional behaviours, hyperarousal and hypervigilance or listenessness and numbness in stressful situations
43
what are the 3 symptom clusters in PTSD
intrusive recollections
avoidant/numbing symptoms
hyperarousal symptoms
44
why might someone be misdiagnosed if providers are not using trauma informed care
seeing what is actually trauma coping may be diagnosed and treated as a seperate condition
45
what is the difference between trauma informed services and trauma specific services
trauma informed is creating safe spaces where people feel in control
trauma specific is treatment and interventions specific for trauma
46
what are the 4 principles of trauma informed care
trauma awareness
emphasis and safety and trustoworthiness
opportunity for choice
strength based and skill building
47
what are the two aspects important for trauma informed practice at a personal level
self awareness and vicarious trauma
48
what are the ABCs of addressing vicarious trauma
Awareness of our needs
Balance between work and rest
Connection to ourselves and something greater
49
what are the 2 key areas of trauma informed practice at the practice level
trauma awareness
language - shift from what is wrong with you to what has happened to you
50
a mental health diagnosis should only be considered and made if _____
only if treatment is being considered
51
what are validated screening tools for depression
PHQ2 and PHQ9
52
what part of the brain is responsible for switching off anxiety
prefrontal cortex
53
what part of the brain is the emotional core that triggers fear and has an immediate response to anxiety
amygdela
54
what part of the brain perpetuates the fear response causing longer term anxiety
BNST
55
what part of the brain is responsible for memory
hippocampus
56
what is the DSM5 criteria for GAD
excess anxiety more than 6 months
difficult to control
3 or more symptoms (tense/on edge, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbances)
significant distress
no other cause
57
what is the DSM5 criteria for panic attacks
recurrent unexpected panic attacks
at least 4 symptoms (palptiations, SOB, chills/heat, unreal/detached, fear of dying, sweating, choking, n/v/d, numbness, shaking, CP, dizzy, losing control)
for at least 1 episode in the following period of 1 month there is continued worry about another attack and/or maladtive changes to prevent another attack
58
true or false: having panic attacks means you have panic disorder
false, other diagnoses can cause panic attack
59
what is the many cause of dysfunction in panic disorder
fear of another panic attack
60
what questionnaire can be used for panic disorder
Panic Attack Questionnaire
61
what is the imaginary audience and what mental illness is it associated with
imaginary brain seen in adolescence where they believe everyone is obsessed with them as they are
connect to social anxiety disorder
62
most adults with SAD have an anxious-ambivilant attatment style. How does this manifest
discomfort in close relationships
difficulty trusting others
greater anxiety about rejection or abandonment
63
what screening tools can be used for social anxiety disorder
the Liebowitcs Social Anxiety Scale
Social Interaction Anxiety Scale
64
what is the DSM5 criteria for social anxiety disorder
fear or anxiety about social situations
fear of acting in a way or showing that will embarras
social situations almost always provoke fear
social situations avoided or endure with extreme discomfort
fear out of proportion to threat
persistent, lasts at least 6 months
clinically significant distress
65
what is acute stress disorder
occuring after significant traumatic events lasting less than 1 month
66
what is the difference between acute stress disorder and PTSD
PTSD lasts beyond 1 months
67
what is DSM5 criteria for acute stress disorder
exposure to extreme threat
9 symptoms
lasts 3 days - 1 month
68
what are the 3 different responses in PTSD
fight or flight
freeze
dorsal vagal nerve (shutting down)
69
what is DSM5 criteria for TPSD
exposure to actual or threatened event
presence of at least 1: (recurrent intrusive memories, dreams with basis in trauma, dissociation flashbacks, intense prolonged psychogical distress)
persistant avoidance of triggers
negative changes in cognition
alteration in arousal and reactivity
more than 1 month
70
what is PTSD with delayed espression
PTSD occuring up to 6 months after the event
71
what is the difference between obsessions and compulsions
obsessions = unwanted intrusive thoughts
compulsions = behaviours, often ritualistic, to try to reduce anxiety
72
true of false: OCD does not have high rates of suicide attmepts
false
73
how are addictions different from compulsions
addictions are feelings of pleasure from the behavior
compulsions are behaviors that are trying to reduce fear and anxiety
74
do OCD symptoms constitute need for a brain scan?
not on their own. although symptoms may be associated with brain tumors, there would be more than just OCD symptoms present
75
what is the DSM5 criteria for OCD
presence of obsessions, compulsions or both
obsessions/compulsions are time consuming
no other cause
level of insight will determine treatment method
76
what screening tool can be used for OCD
obsessive compulsive inventory screening tool
77
what are some types of OCD
checking
contaminational/mental contamination
symmetry/ordering
ruminations/intrusive thoughts
hoarding (can be its own diagnosis or OCD if hoarding is down because of an obsessive worry or fear)
78
how might you differentiate a tic from a focal seizure
tic - people continue to go about their business
focal seizure - behavior arrest
tic - does not happen during sleep
focal seizure - can happen while awake or asleep
79
in terms of seasonal affective disorder, what is photoperiod and what is phase shift theory
photoperiod - seasonal changes in the length of daylight
phase shift theory - sleep wake cycle out of sync, similar to jet lag
80
what is the difference between the following seasonal affective disorders:
winter
summer
reverse
subsyndromal
winter - peak in winter and remits by spring
summer - onset in spring and remits in fall
reverse - in spring and summer but more hypomanic and hyperactivity
Subsyndromal - winter blues, not as severe and not as long
81
seasonal affective disorder is affected more by: temperature or latitude
latitude, the farther you are from the equator the more at risk you are
82
what are treatment options for seasonal affective disorder
light therapy
exercise
vitamin D
sometimes anti-depressants
83
what is adjustment disorder
anxiety/sadness/hopelessness occurring after significant life stress that is self limiting and resolves within 6 months
84
what is used for treatment of adjustment disorder
usually support, encouragement and reassurance is all that is needed. Sometimes counselling and psychotherapy. Monitor for SI
85
what is DSM5 criteria for adjustment disorder
symptoms due to identifiable stressor in last 3 months
clinically significant and includes at least one:
distress out of proportion or impairment in daily life
not another condition
not normal bereavement
once stressor gone, resolves within 6 months
86
what should you have a high suspicion for when people come in with vague complaints and no organic cause can be found
MDD
87
true of false: somatic complaints or not part of MDD
false, somatic complaints are valid indicators of depression
88
other than MDD, what other diagnosis should you consider for someone presenting with depressive symptoms and why
bipolar, often initially presents with depressive episode
89
what are the brain pathways for the following and indicated in MDD:
Serotonin
Norepi
dopamine
Serotonin - Rathe
Norepi - Locus coerules
dopamine - VTA
90
what screening tools can be used for MDD
Hamilton depression scale
PHQ9
Geriatric depression scale
91
what is the acronym SIGECAPS used for and what does it stand for
for the DSM5 criteria for MDD - at least 5 of the following symptoms during the same 2 week period and must include depressed mood and anhedonia
Sleep disturbances
Interest reduce
Guilt or worthlessness
Energy loss and fatigue
Concentration problems
Appetite changes or weight changes
Psychomotor agitation or retardation
Suicidal thought with or without intent
92
what is complicated grief
worsening, unrelenting state of mourning
93
is complicated grief seen more often with the loss of a parent or the loss of a child
loss of a parent
94
what is dysthymia
chronic low grade depressive like symptoms lasting more than 2 years
95
early onset dysthymia (before age 21) increases risk for what other mental illness
personality disorder
substance use disorder
96
what are the 2 subtypes of dysthymia and which medications may work better for each
anxious - SSRI
anergic - norepi and dompamine increasing medication
97
what is the DSM5 criteria for dysthymia
depressed mood most days for at least 2 years
at least 2 of the following:
disordered eating, disordered sleep, low energy, low self esteem, poor concentration, hoplessness
never without symptoms for more than 2 months
never had manic or hypomanic episode
98
how is a depressive episode in MDD differentiated from BPD
they present exactly the same but BPD must have history of manic or hypomanic episode at least once
99
true or false: the suicide risk is extremly elevated in people with BPD
true
100
migraine is highly associated with what mental illness
BPD
101
what are some physical causes of mood cycling that is not BPD
thyroid disease, STI, accidents
102
how is hypomania different from mania
hypomania is elevated mood for shorter time (4-7 days) and criteria for mania but no significant impairment
103
what are the categories for BPD
BPD1 - most severe, major depression and manic episodes
BPD2 - less severe and more common, depression with hypomania
104
what is the DSM5 criteria for mania
persistently elevated, expansive, or irritable mood with increased activity for more than 1 week
at least 3 of the following:
grandiosity, decreased need for sleep, pressured speech, racing thoughts, distractibility, high risk activities
105
why must you closely follow someone who has newly been prescribed antidepressants for MDD
because if it is BPD and they just havent had a manic episode yet, antidepressants can cause a manic episode
106
what is used to treat bipolar
combo antidepressants, mood stabalizers and sometimes neuroleptics
107
what screening tool can be used for BPD
Mood disorder questionnaire
CDI scale
108
true or false: patients suspected of having BPD should be referred to psychiatry
true
109
should you treat mild bipolar depression?
yet but treat with caution and closely monitor for medication side effects
110
what is the pneumonic DIGFAST used for and what does it stand for
symptoms of mania
Distractibility
Impulsivity, irresponsibility
Grandiose thoughts
Family history
Appetite changes and increased activity
Sleep disturbances
Talkative
111
can hypomania present with psychotic symptoms?
no, if psychotic symptoms are present in a mania presentation, it is mania
112
what is the DSM5 criteria for mania
distinct period of abnormally persistent elevated or irritable mood lasting at least 1 week
at least 3 symptoms (grandiosoty, decreased need for sleep, pressured speech, racing thoughts, distractibility, increased goal directed activity, risk taking behavior)
significant impairment and not due to medicaiton or substance
113
when might you consider CT, MRI or labs in a person presenting with mania
neuro symptoms, onset later in life, dramatic change in symptoms or episodes
114
what is the DSM5 criteria for hypomania
same as mania except:
lasts at least 4 days
causes less dysfunction but still different from baseline
no psychotic features or need to hospitalize
115
what is cyclothymia
episodes of both hypomania and low mood but not severe enough to fit criteria for MDD or mania
116
what is the DSM5 criteria for cyclothymia
recurrent episodes of low level hypomania and mild depression that do not meet criteria for hypomania or MDD and over a 2 year period
present at least half the time and no longer than 2 months at a time without symptoms
MDD, mania or hypomania criteria have never been met
significant distress or impair function
117
are depressive episodes required for a BPD diagnosis?
no, some people will only cycle between mania and hypomania
118
what is the acronym FESTIVAL and what is it used for
symptoms for depression and mania for BPD
Feeling low/high
Energy low/hig
Sleep more/less
Thinking slow/rapid
Interest low/rapidly changing
Value in self low/grandiose
Aches present/disappear
Live - suicidal/feel like they will live forever
119
is BPD1 or BPD2 more common?
BPD2
120
how does the diagnosis for BP1 and BP2 differ?
BP1 requires DSM5 mania and hypomania or depression
BP2 only requires hypomania with MDD
121
are people with BP1 or BP2 more likely to complete suicide
BP2
122
when is the usual onset of shizophrenia in men? in women?
men - late adolescence to mid thirties
women - mid twenties to early thirties
123
what are the features of psychosis
delusions
hallucinations
disorganized speech
behavior
124
what are each of the following delusions:
persecutory
Grandiose
erotomania
nihilistic
somatic
persecuroty - being watched, in danger
grandiod - super powers, wealth, notoriety
erotomania - others in love with them
nihilistic - something catastrophic will happen
somatic - something wrong with their body
125
what hallucinations are most common in delirium and dementia? which are most common in schizophrenia
delerium and dementia - visual
schizophrenia - auditory
126
disorganized speech in schizophrenia will present with one or more of the following: incoherence, derailment, tangential thoughts. What do each of these mean
incoherence - random words in sentences have the "song" of the language but no cognitive sense
Derailment - topic or train of thought changes without logical connection
Tangential - rambling from one topic to another, losing original topic altogether, often seen with answering questions
127
what is meant by positive and negative behaviors when discussing schizophrenia
Positive behaviors involve some kind of action (agitation, restlessness, calling out, violence)
Negative behaviors are little or no action (catatonia, avolition, mutism, anhedonia)
128
what needs to be done for patients that are catatonic?
hospitalize, this is severe mental distress
129
what other differentials might you consider for schizophrenic type symptoms
brain tumors
dementia
delirium
130
which two street drugs increase risk for schizophrenia the most?
methamphetamines
cannabis
131
what is cannabis induce acute persistent psychosis
psychotic symptoms that persist past the initial intoxication but usually resolve fairly quickly and do not recur without re use of cannabis
132
true or false: age of initial exposure to cannabis does not change the risk for psychosis
false, earlier exposure (before 14-17 years old) is assocaited with higher risk for psychosis
133
true or false: exposure to cannabis in adolescence increases risk for psychotic disorders in adulthood
true
134
what screening tool may be used to help differentiate delirium from dementia
The Confusion Assessment Method
135
when differentiating schizophrenia from MDD with psychotic features, what are some things that are seen in each to help differentiate
MDD is not likely to have disorganized speech or bizarre behavior and schizophrenia is not likely to be preceeded by depression
136
what age group do psychotic disorders typically emerge?
adolescence to 30's
137
what is brief psychotic disorder
more than a day but less than a month
at least one of the following plus grossly disorganized or catatonic behavior:
delusions
hallucinations
disorganized speech
138
what is schizophreniform disorder
less than 6 months
at least one of the following:
delusions
hallucinations
disorganized speech
May also have:
grossly disorganized or catatonic
negative symptoms
no history of manic depressive episodes
139
what is the difference between schizophrenia and schizophreniform
schizophrenia must persist past 6 months and have significant loss of function
140
what is schizotypal personality disorder
chronic low level symptoms with personality disturbance, better global functioning than schizophrenia but aggresiveness is common
