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NRSG 126: Mental Health > [Exam 3] Chapter 15: Obsessive-Compulsive and Related Disorders > Flashcards

[Exam 3] Chapter 15: Obsessive-Compulsive and Related Disorders Flashcards

1
Q

What was OCD previously classified as?

A

An anxiety disorder due to sometimes extreme anxiety that people experience

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2
Q

What does the spectrum approach include?

A

Repetitive behaviors of various types: Self-soothing behaviors, such as trichotillomania, dermatillomania or onychophagia; reward seeking behaviors such as hoarding, kleptomania, pyromania, or oniomania and disorders of body appearace

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3
Q

Spectrum Approach: What are the self-sooth behaviors?

A

Trichotillomania

Dermatillomania

Ocychophagia

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4
Q

Spectrum Approach: What are reward-seeking behaviors?

A

Hoarding, kleptomania, pyromania, or oniomania

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5
Q

Spectrum Approach: Disorders of body appearance or function includes what?

A

Body dysmorphic disorder (BDD)

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6
Q

Obsessive-Compulsive Disorder: What are obsessions?

A

Recurrent, persistent, intrusive, and unwanted thoughts, images, or impulses that cause marked anxiety and interfere with interpersonal, social, or occupational function. Believe they have no control over them

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7
Q

Obsessive-Compulsive Disorder: What are compulsions?

A

Ritualistic or repetitive behaviors or metnal acts that a person carries out continuously in an attempt to neutraize anxiety. This includes repetitive hand washing

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8
Q

Obsessive-Compulsive Disorder: What are counting rituals?

A

Each step taken, ceiling tiles, concrete blocks or desks in a classroom

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9
Q

Obsessive-Compulsive Disorder: What are checking rituals?

A

repeatedly making sure the door is locked or coffee is turned off

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10
Q

Obsessive-Compulsive Disorder: What are ordering rituals?

A

arranging and rearranging furniture or items on a desk or shelf in perfect order

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11
Q

Obsessive-Compulsive Disorder: What is exhibiting rigid performance?

A

getting dressed in unvarying pattern

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12
Q

Obsessive-Compulsive Disorder: What are aggressive urges?

A

for instance, to throw ones child against a will

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13
Q

Obsessive-Compulsive Disorder: What are some other examples of compulsions

A

washing until skin raw
Praying

Touching or rubbing

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14
Q

When is OCD diagnosed?

A

Only when these thoughts , images, and impulsees consume the person or they are compelled to act out the behaviors to a point at which they interfere with person and social functions

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15
Q

Obsessive-Compulsive Disorder: How may person feel if they don’t perform the rituals?

A

They use it to alleviate anxiety and prevent terrible thoughts

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16
Q

OCD & Onset/Clinical: When does it start?

A

Childhood, especially in males. Females, in their 20s.

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17
Q

OCD & Onset/Clinical: Early onset is more likely to affect who?

A

males and they have more severe symptoms, m ore comorbid diagnoses, and a greater likelihood of family history of OCD

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18
Q

OCD & Related Disorders: What is Excoriation disorder? (Dermatillomania)

A

Self soothing behavior. behavior is an attempt of people to soothe or comfort themselves, not that skin picking is a positive sensation

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19
Q

OCD & Related Disorders: What is necessary to treat excoriation disorder?

A

Medicine, surgery and plastic surgery as well at psychiatry on tx team.

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20
Q

OCD & Related Disorders: Alternative therapies for excoriation?

A

yoga, acupuncutre, and biofeedback are helpful when included

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21
Q

OCD & Related Disorders: What is trichotillomania?

A

Chronic hair-pulling , causes distress and functional impairment

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22
Q

OCD & Related Disorders: Onset for trichotillomania?

A

Childhood but can persist into adulthood with development of anxiety and depression.

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23
Q

OCD & Related Disorders: Trichotillomania occurs most often with who

A

females than males

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24
Q

OCD & Related Disorders: trichotillomania tx?

A

behavioral therapy

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25
Q

OCD & Related Disorders: What is BDD?

A

Preoccupation with an imagined or slight defect in physical appearance that causes significant distress for the individual and interferes with functioning in daily living

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26
Q

OCD & Related Disorders: What does someone with BDD often worry about?

A

Defect, often blaming of lifes problems on their flawed appearance. This is why they are unsuccessful at work, feel unhappy, etc.

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27
Q

OCD & Related Disorders: What tx do those with BDD try to do?

A

Elective cosmetic surgery, but person is still dissatisfied and ifnds another flaw.

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28
Q

OCD & Related Disorders: Overlap between BDD and other diagnoses?

A

Anxiety, depression, social anxiety disorder, adn excoriation didsorder

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29
Q

OCD & Related Disorders: Tx for BDD?

A

SSRI effective in relapse prevention

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30
Q

OCD & Related Disorders: What is hoarding disordeer?

A

Progressive, debilitating compulsive didsorder only recently diagnosed on its own.

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31
Q

OCD & Related Disorders: Age for hoarding disorder?

A

20-30 and common with 2-5 % of population.

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32
Q

OCD & Related Disorders: What does hoarding involve?

A

excessive acquisition of animals or apparantely useless things and cluttered living spaces

33
Q

OCD & Related Disorders: Tx for hoarding disorder?

A

Meds, CBT, Self-Help groups, or the involvement of outside community agencies

34
Q

OCD & Related Disorders: What is Onychophagia?

A

Chronic nail-biting. Is a self-soothing behavior

35
Q

OCD & Related Disorders - Onychophagia: Onset for this?

A

Childhood, and decrease by age 18

36
Q

OCD & Related Disorders - Onychophagia: If lead into adulthood, what problems can this cause?

A

Psychosocial problems or cause complications involving nails and oral cavity

37
Q

OCD & Related Disorders - Onychophagia: Effective tx for this?

A

SSRI

38
Q

OCD & Related Disorders - Kleptomania: What is this?

A

Compulsive stealing, is a reward-seeking behavior. Reward is not the stolen item but rather the thrill of stealing and not getting caught

39
Q

OCD & Related Disorders - Kleptomania: More common with who?

A

females with comorbid diagnoses of depression adn substance use

40
Q

OCD & Related Disorders - Kleptomania: Tx?

A

Longer term therapy as opposed to limited 10-12 sessions

41
Q

OCD & Related Disorders - Oniomania: What is this?

A

Compulsive buying is a reward-seeking behavior. Pleasure is in acquiring the purchased object rather than the enjoyment of its use

42
Q

OCD & Related Disorders - Oniomania: OCD & Related Disorders - Oniomania: Who does this affect?

A

Most commonly females in early 20s. Runs in families who have high comorbidity for depression and substance use

43
Q

OCD & Related Disorders - Body Identity Integrity Disorder (BIID): What is this?

A

Term given to people who feel “overcomplete” or alientated from a part of their body and desire amputation

44
Q

OCD & Related Disorders - Body Identity Integrity Disorder (BIID):How do people describe feelings about this?

A

Feelings of anguish and distress with their intact bodies and report feeling “natural” after amputation

45
Q

OCD & Related Disorders - Body Identity Integrity Disorder (BIID): What extreme measures do people take to get an amputation?

A

Packing limb on dry ice until damage so advanced that they have to remove it.

46
Q

OCD & Etiology: Cognitive models arise from who?

A

Aaron Beck

47
Q

OCD & Etiology: What does the cognitive model describe the persons thinking as?

A
  1. Believes one thoughts are overly important

Perfectionism and the intolerance of uncertainity

Infalted personal responsibility and overestimation of the thread posed on ones thoughts.

48
Q

OCD & Etiology: Cognitive model focuses on what?

A

Childhood and environmental experiences by growing up.

49
Q

OCD & Tx: Optimal tx combined what?

A

Medication adn behavioral therapy

50
Q

OCD & Tx: First line choices?

A

SSRI Antidepressants:

Fluvoxamine (Luvox) and Sertraline (Zoloft) followed by Venlafaxine (Effexor)

51
Q

OCD & Tx: Tx resistant OCD may respond to what?

A

2nd gen antipsychotics such a:

Risperidone (Risperdal)

Quetiapine (Seroquel)

Olanzapine (Zyprexa)

52
Q

OCD & Tx: CHildren and adolescents respond best with what?

A

behavioral therapy and SSRI antidepressants

53
Q

OCD & Tx: What does behavioral therapy involve?

A

Exposure and response prevention

54
Q

OCD & Tx: What does exposure involve?

A

assisting the client in deliberately confronting the situations and stimuli that he or she usually avoids

55
Q

OCD & Tx: What does response prevention focus on?

A

delayingor avoiding performance of rituals. Person learns to tolerate the thoughts and anxiety and to recognize that it will recede.

56
Q

OCD & Assessment: What scale is used here?

A

Yale-Brown Obsessive-Compulsive Scale. Can guide their assessment of client with OCD

57
Q

OCD & History: When does a client seek tx?

A

When obsessions become too overwhelming or when compulsions interfere with daily life or both

58
Q

OCD & History: When are clients hospitalized?

A

When they have become compeltely unable to carry out their daily routines.

59
Q

OCD & History: Where is most tx conducted?

A

Outpatient

60
Q

OCD & Appearance/Motor: How do these patients appear?

A

Tense, anxious, worried, adn fretful.

61
Q

OCD & Mood/Affect: What do they report here?

A

Report ongoing feelings of anxiety in response to obsessive thoughts, images, urges

62
Q

OCD & Thought Process/Content: How does client describe obsessions?

A

Arising from nowhere. Harder they try to stop it, the more intense it becomes.

63
Q

OCD & Judgement/Insight: How do they feel about their obsessions?

A

Recognize they are irrational but they cannot stop them.. They know that a house is safe but cannot act on them

64
Q

OCD & Self-Concept: How does self-concept appear here?

A

They feel like they are going crazy. Feelings of powerlessness to control the obsessions

65
Q

OCD & Intervention - Using Therapeutic Communication: What does the nurse encourage the client to do?

A

Talk about feelings and describe them in as much detail as the clienet can tolerate

66
Q

OCD & Intervention - Txing Relaxation and Behavioral Techniques: What relaxation techniques cna be taught?

A

Deep breathing, progressive muscle relaxation and guided imagery

67
Q

OCD & Intervention - Txing Relaxation and Behavioral Techniques: When should relaxation teaching take place?

A

When client’s anxiety is low so he or she can learn more effectively

68
Q

OCD & Intervention - Txing Relaxation and Behavioral Techniques: Why would keeping a diary be useful?

A

To chronicle siutations that trigger obsessions , the intesnisty of anxiety, the time spend performing rituals and avoidance behaviors

69
Q

OCD & Intervention - Completing a Daily Routine: What must nurse account for here?

A

If they have a 45 minute ritual before breakfast, plan the time intot eh clients schedule

70
Q

OCD & Intervention - Completing a Daily Routine: What changes may the nurse and client make?

A

TO limit the morning ritual to 40 minutes, then 35, and so forth

71
Q

OCD & Intervention - Client and Fam Education: What to teach client?

A

Abotu OCD

About importance of talking openly about obsessions

Discuss necessary behavioral techniques for managing anxiety

72
Q

OCD & Intervention - Client and Fam Education: What to teach families?

A

Avoid giving advice to think of something else

Avoid trying to fix problem

Be patient with family member discomfort

73
Q

OCD & Eval: Effective when?

A

When OCD symptoms no longer interfere with clients ability to carry out responsibilites.

74
Q

OCD & Eval: What should client do when obsessions occur?

A

Client manages resultng anxiety without engaging in complicated or time-consuming rituals

75
Q

OCD & Practice: BEst first line of treatment for OCD?

A

CBT

76
Q

OCD & Practice: What is done during CBT?

A

CBT that encompasses exposure and response prevention. Delivered in variety of settings

77
Q

OCD & Community Based Care: TX for OCD involves what?

A

Medication and CBT.

78
Q

OCD & Community Based Care: What can therapist teach client?

A

Exposure and response prevention techniques but client will need to practice these at home.

79
Q

OCD & Community Based Care: What are some new small studies therapies that have been tried?

A

Bibliotherapy, telephone-delivered CBT, and computerized CBT

NRSG 126: Mental Health (24 decks)

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