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Exam 5 Mental Health Flashcards

0
Q

2 or more people who develop an interactive relationship and share at least on common goal or issue

A

Therapeutic groups

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1
Q

Treatment intervention in which a trained leader establishes a group for the purpose of treating pts with psychiatric disorders

A

Group psychotherapy

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2
Q

When members recognize they are not alone, other members have similar thoughts, feelings, & problems

A

Universality

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3
Q

When you help others

A

Altruism

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4
Q

When you have accurate info shared

A

Imparting of information

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6
Q

Corrective recapitulation of the primary family group

A

Reenact & connect family values

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7
Q

catharsis

A

sense of relief

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8
Q

maintenance group re-enforce or help maintain good behavior

A

support groups

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9
Q

name the types of activity groups

A

recreational

creative

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10
Q

what do educational groups help with

A

give pts information about medications, coping skills, social skills etc

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11
Q

family becomes involved with therapy

A

family therapy

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12
Q

what are the goals of family therapy

A

understanding family dynamics
mobilize family strengths & resources
restructure maladaptive family behavioral styles
help strengthen family problem solving behaviors
assess and treat family and patient

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13
Q

Freud

A

father of psychology
first to identify personality development by stages, the first 5 years are the most important, all mental disorders stem from issues from childhood that weren’t involved

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14
Q

Levels of awareness

A

conscious
preconscious
unconscious

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15
Q

material within awareness is only a small part of the mind

A

conscious

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16
Q

refers to memory that can be recalled to consciousness with some effort

A

preconscious

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17
Q

all the memories, conflicts, and experiences that have been repressed and cannot be recalled at will without assistance of a therapist

A

unconscious

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18
Q

cannot tolerate frustration, lacks ability to problem solve, “pleasure principle”, at birth we are all Id, source of all drives, instincts, needs, genetic inheritance

A

Id

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19
Q

rational self, provides logic & reason, problem solver, and reality tester, strives to maintain harmony
“reality principle”

A

Ego

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20
Q

represents moral component, last to develop, concerned with right and wrong, opposite of Id

A

superego or conscience

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21
Q

what side of the brain is conscious mind, logic, reason, math, reading, writing, language, analysis, Ego

A

left

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22
Q

what side of the brain is unconscious mind, imagery, creativity, synthesis, dreams, symbols, emotions, Id

A

right

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23
Q

why does the ego develop defense mechanisms?

A

to deal with anxiety by preventing conscious awareness of threatening feelings, we cant survive without them

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24
Q

covering us a real or perceived weakness by emphasizing a trait one considers more desirable

A

compensation

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25
Q

refusing to a acknowledge the existence of a real situation or the feelings associated with it

A

denial

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26
Q

transfer of feelings to another that is considered less threatening or that is neutral

A

displacement

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27
Q

an attempt to increase self worth by acquiring certain attributes and characteristics of an individual one admires

A

identification

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28
Q

an attempt to avoid expressing actual emotions association with a stressful situation by using the intellectual processes of logic reasoning and analysis

A

intellectualization

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29
Q

attributing feelings or impulses unacceptable to ones self to another person

A

projection

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30
Q

attempt to make excuse or formulate logical reasons to justify unacceptable feelings or behaviors

A

rationalization

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31
Q

preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opp. thoughts or types of behaviors

A

reaction formation

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32
Q

responding to stress by retreating to an earlier level of development and the comfort measures associated with that level of functioning

A

regression

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33
Q

involuntary blocking unpleasant feelings and experiences from ones awareness

A

repression

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34
Q

rechanneling of drives or impulses that are personally or socially inacceptable into activities that are constructive

A

sublimation

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35
Q

a voluntarily blocking of unpleasant feelings and experiences from ones awareness

A

suppression

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36
Q

symbolically negating or canceling out an experience that one finds intolerable

A

undoing

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37
Q

occurs when emotional conflict or stressors are handled by attributing negative qualities to self or others. when devaluing another, the individual appears good by contrast

A

devaluation

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38
Q

Eriksons developmental theory stages of personality development

A

emphasis on stages of development, each stage is an emotional crisis, degree of mastery is related to the degree of maturity that the adult achieves, 8 stages

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39
Q

views abnormal behavior as part of a disease

A

neurobiological model

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40
Q

cerebrum

A

largest part of brain, associated with thought and action, divided into 4 sections called lobes

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41
Q

frontal lobe

A

reasoning, planning, parts of speech, movement, emotions, problem solving

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42
Q

parietal lobe

A

associated with movement, spatial orientation, recognition, perception of stimuli

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43
Q

occipital lobe

A

associated with visual processing

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44
Q

temporal lobe

A

associated with perception and recognition of auditory stimuli, memory, and speech

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45
Q

limbic system

A

“emotional brain”, found in the cerebrum, regulates emotion and memory. connects the lower and higher brain functions, influences motivation, mood, sensations of pain and pleasure

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46
Q

parts of limbic system

A 
thalamus
hypothalamus
cingulate
amygdala
hippocampus
basal ganglia
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47
Q

all sensory inputs through it to the higher levels of the brain

A

thalamus

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48
Q

sits at the top of the brainstem, while small, it controls autonomic nervous system center for emotional response and behavior, regulates body temperature, food intake, water balance, and thirst, and controls endocrine system

A

hypothalamus

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49
Q

serves as a conduit of messages to and from the inner limbic system

A

cingulate

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50
Q

appears to be responsible for the influence of emotional states on sensory inputs

A

amygdala

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51
Q

important in the transition of information from short term to long term memory

A

hippocampus

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52
Q

plays a role in planning and coordinating motor movements and posture

A

basal ganglia

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53
Q

acetylcholine

A

voluntary movement, learning, memory and sleep
too much=depression
too little=dementia

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54
Q

dopamine

A

correlated with movement, attention, and learning
too much=schizophrenia
too little=Parkinson’s disease

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55
Q

norepinephrine

A

associated with eating, alertness
too much=schizophrenia
too little=depression

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56
Q

epinephrine

A

involved in energy and glucose metabolism

too little=depression

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57
Q

serotonin

A

plays a role in sleep, mood, appetite, and impulsive aggressive behavior
too little=depression, anxiety disorders (esp. OCD)

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58
Q

GABA

A

inhibits excitation and anxiety

too little=anxiety,

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59
Q

endorphins

A

involved in pain relief and feelings of pleasure and contentedness

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60
Q

voluntary patients

A

patient or guardian applies for Tx and can sign out of Tx

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61
Q

involuntary patients

A

mental illness is not incompetent, state must prove mentally ill and dangerous

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62
Q

evaluation and emergency care (involuntary tx)

A

72 hours, those who are dangerous to self or others or gravely disabled

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63
Q

certification for observation and tx (short term)

A

14 days, psychiatrist must see in 24 hours, disorder must be treatable, probable cause required by 4 amendment (search and seizure)

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64
Q

extended or indeterminate commitment (long term)

A

need prolonged care but refuse voluntarily. 3, 6, 12 months. requires a court hearing

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65
Q

hospital based care

A

short term, crisis intervention & safety, D/C planning, psychotherapeutic management model

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66
Q

outpatient

A

mental health clinics, private practices, primarily for counseling

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67
Q

partial programs

A

day program, structured activity, and tx during the day, pt returns to home in evening

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68
Q

residential services

A

(stokley center) extended care facilities, group homes, halfway homes, living programs, shelters

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69
Q

eustress

A

good stress

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70
Q

something that triggers stress to be real or perceived

A

stressor

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71
Q

natural stimulant made in adrenal gland, epinephrine, affects ANS (increase of HR, pupils dilate, sweat) fight/flight response

A

adrenalin in action

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72
Q

alarm triggers response; body reacts; return to homeostasis

A

alarm and adrenaline

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73
Q

results in higher than normal amounts of adrenaline; adrenaline overload takes a toll on the body (insomnia, nausea, dizziness, depression)

A

prolonged stress

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74
Q

name general stress reduction techniques

A

relaxation, reframing, sleep, exercise, decrease caffeine

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75
Q

persistent re experiencing with a highly traumatic event that involves actual or threatened death or serious injury to self or others

A

post traumatic stress disorder

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76
Q

when do Sx of PTSD usually appear

A

3 months after trauma but a delay of months or years is not uncommon

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77
Q

a dissociative experience during which the event is relived and the person behaves as though he/she is experiencing the even t at that time

A

flashbacks

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78
Q

what are the major features of PTSD

A

flashbacks, persistent avoidance, numbing of general responsiveness (diff sleeping, concentrating, hyper-vigilance)
difficulties with relationships, trust, child/spouse, chemical abuse

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79
Q

occurs within one month after exposure to a highly traumatic event, such as those as PTSD

A

acute distress disorder, must display 3 dissociative sx either during or after the traumatic event, if it resolves within 4 weeks its acute distress disorder, if it persists then it is PTSD

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80
Q

name the dissociative sx of

A

sense of numbness, detachment, reduced awareness of surroundings, de-realization, depersonalization, dissociative amnesia

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81
Q

a feeling of anticipation, generally unpleasant

A

anxiety

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82
Q

abnormal anxiety

A

remains when the danger or stressors are gone

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83
Q

mild anxiety

A

can id things that are disturbing and are producing anxiety, slight discomfort, restlessness, impatience, foot or finger taping, lip chewing, fidgeting, able to work effectively toward a goal and examine alternatives

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84
Q

moderate anxiety

A

has narrow perceptual field, grasps less of what is going on, able to solve problems but not at optimal ability, voice tremors, shakiness, diff concentrating, somatic complaints (urinary freq. urgency, HA, insomnia) increase HR, RR, pacing, banging hands on table

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85
Q

severe anxiety

A

has greatly reduced perceptual field, attention is scattered, absorbed with self, unable to see connections between events or detains, has distorted perceptions, feelings of dread, confusion, sense of impending doom, hyperventilation, tachycardia, loud and rapid speech, threats and demands

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86
Q

panic

A

unable to focus on environment, experiences the utmost state of terror and emotional paralysis, may have hallucinations or delusions that take the place of reality, may be mute or extreme psychomotor agitation, experience of terror, immobility or severe hyperactivity or flight, severe shakiness, sleeplessness, out of touch with reality

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87
Q

primary method that our ego uses to control or manage anxiety

A

defense mechanisms

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88
Q

what is the most common form of psychiatric disorder in US

A

anxiety

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89
Q

etiology of anxiety

A

genetic, limbic system, neurotransmitters, behavioral/cognitive (learned behavior)

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90
Q

how does the cingulate act in anxiety

A

part that is associated with anxiety disorders, stores memories, emotions

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91
Q

how does the frontal cortex act in anxiety

A

interprets initial threat (threat or not)

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92
Q

how does the hypothalamus act in anxiety

A

activates fight or flight response

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93
Q

how does the amygdala act in anxiety

A

registers fear responses and stores it

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94
Q

how does the hippocampus act in anxiety

A

memory related to fear

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95
Q

serotonin in anxiety

A

level is decreased which causes anxiety

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96
Q

what is usually given for anxiety

A

Benzodiazepines

97
Q

panic attack

A

sudden onset, feelings of terror, “out of blue” fear of losing control, feels like having heart attack

98
Q

S/sx of panic attack

A

CP, palpations, diff. breathing, N/V, hot flashes, chills, feels like choking

99
Q

intense excessive anxiety or far about being in places or situations from which escape might be difficult or embarrassing

A

panic attack with agoraphobia

100
Q

irrational fear of an object or situation that persists although the person may recognize it as unreasonable

A

phobias

101
Q

need to control themselves, others, and environment

A

obsessive compulsive disorder

102
Q

thoughts, impulses or images that persist and recur so that they cannot be dismissed from the mind, can cause extreme anxiety

A

obsession

103
Q

ritualistic behaviors an individual feels compelled to perform to reduce anxiety

A

compulsion

104
Q

excessive collecting of items, failure to discard excessive amounts of these items, usually associated with OCD

A

hoarding

105
Q

excessive worrying and anxiety about numerous things lasting 6 months or longer

A

generalized anxiety disorder

106
Q

Sx of generalized anxiety disorder

A

restlessness, fatigue, poor concentration, irritability, tension, sleep disturbance

107
Q

substance induced anxiety disorder is characterized by sx of

A

anxiety, panic attacks, obsessions, compulsions that develop with the use of a substance or within a month of stopping use of the substance involved

108
Q

used for disorders in which anxiety of phobic avoidance predominates but the symptoms don’t meet full diagnostic criteria for a specific anxiety disorder

A

anxiety disorder not otherwise specified (NOS)

109
Q

SSRI

A

antidepressants
serotonin reuptake inhibitors
ex. Paxil, Prozac, Zoloft
don’t use with ETOH, may take 4-6 wks to realize full benefit, don’t stop suddenly

110
Q

why are SSRI’s not given to bipolar pts

A

bc they can cause manic episodes

111
Q

SSNRI

A

serotonin norepinephrine reuptake inhibitors

ex. Cymbalta, Effexor

112
Q

Anxiolytics (antianxiety)

A

Benzodiazepines
potentiate GABA decrease neuronal excitability, short term basis bc of dependence, produces calm effect
no ETOH, don’t stop suddenly, don’t take if prego, no caffeine
Ex. Ativan, valium, Xanax, Klonopin

113
Q

Beta blockers

A

propranolol

used for GAD or panic, blocks beta adrenergic receptors in sympathetic NS causing a relaxation response

114
Q

BuSpar

A

antianxiety
doesn’t cause dependence
need 2-4 wks to reach full effect, long term Rx, should be taken regularly
SE: HA, dizziness, lightheadedness, nauseas, insomnia

115
Q

Kava Kava

A

causes liver toxicity

116
Q

valarian

A

root, put in tea, causes HA, dizziness, N/V

117
Q

the expression of psychological stress through physical symptom, convert anxiety into physical symptoms, not caused by substance, possible link to repressed anxiety

A

somatoform disorders
usually obsessed on how their body is working/effected
“hysterical neurosis”

118
Q

what is the prevalence of somatoform disorders

A

est. 30% mostly female

119
Q

etiology of somatoform

A

not genetic, but runs in families, pain is r/t repressed anxiety, learned from environment, cognitive: focus on body sensations & misinterpret their meanings

120
Q

intentionally produced physical or psychological s/sx to assume the sick role, no intent for economic gain

A 
factitious disorder (not a somatoform disorder)
*most severe form is Munchausen syndrome
121
Q

conscious effort to produce symptoms for benefit, usually for economic gain (disability), difficult to prove or disprove, often medication seeking

A

malingering disorder (not a somatoform disorder)

122
Q

syndrome of multiple somatic complaints that cannot be explained medically and are associated with psychosocial distress and long term seeking of assistance from healthcare professionals

A

somatization disorder

123
Q

characteristics of somatization disorder

A

vague, dramatized, exaggerated, report significant distress, anxiety & depression in history, report being ill for prolonged time with variety of Sx, chronic and relapsing pain, suicide threats and attempts are not uncommon

124
Q

prevalence of somatization disorder

A

females, lower educational levels, rural areas, non white

125
Q

Sx of somatization

A

pain, GI (N, V, D), sexual sx (irreg. period, ED), neurological (paralysis, numbness)
*most common

126
Q

pain in one or more anatomic sites, causes clinically significant distress or impairment in social, occupational, or other important areas of functioning, anxiety usually triggers the pain, not intentionally produced

A

pain disorder

127
Q

characteristics of pain disorder

A

frequent visits to MD to obtain relief, excessive use of analgesics, requests for surgery, Sx of depression, dependence on addictive substances

128
Q

an unrealistic or inaccurate interpretation of physical sx or sensations, leading to preoccupation and fear of having serious illness

A

hypochondriasis

129
Q

characteristics of hypochondriasis

A

over exaggeration, fear of disease/illness, preoccupation with sx, extreme worry, refuse to see mental health professional, chronic & relapsing, sx worsen with stress, convinced not receiving good care, MD shopping, OC traits, read about disease or hear about someone they know with the disease and causes alarm on their part

130
Q

loss of or change in body function resulting from a psychological conflict, the physical sx of which cannot be explained by any known medical disorder or pathophysiological mechanism. Ex. blindness, numbness, loss of hearing

A

conversion disorder (very rare)

131
Q

La belle indifference

A

lack of concern, often a clue to MD that the problem may be psychological rather than physical, affect voluntary motor or sensory functioning suggestive of a neurological disease, pseudoneurologial (seizures, paralysis, anosmia, pseudocyesis), not fabricated

132
Q

prevalence

A

more common in females

133
Q

commonly seen in community, psychiatric, cosmetic surgery and dermatological settings

A

body dysmorphic disorder

134
Q

prevalence with body dysmorphic disorder

A

common in women, usually have OCD, may avoid work/school, low self esteem, commonly involves face

135
Q

what is the primary gain for a pt with somatoform disorder

A

conversion sx enable the individual to avoid difficult situations or unpleasant activities about which he/she is anxious
(get out of something they don’t want to do)

136
Q

what is the secondary gain for a pt with somatoform disorder

A

gaining attention or support not otherwise forthcoming

137
Q

what is the communication style for a pt with a somatoform disorder

A

hard time talking about feelings, but they can talk about their S/Sx, always focus on physical, become dependent on Rx to relieve the anxiety

138
Q

Key point about somatoform disorder symptoms

A

not intentional or under the conscious control of the PT, unlike factitious disorders

139
Q

what is the hallmark of dissociative disorders

A

disturbances in the normally well-integrated continuum of consciousness, memory, identify, and perception

140
Q

unconscious defensive mechanism to protect the pt against overwhelming anxiety

A

dissociation

141
Q

prevalence of dissociative disorders

A

rare, occur at any age group , often seen in military or POW camps

142
Q

etiology of dissociative disorders

A

unknown but r/t stress (traumatic events)

limbic system is involved, traumatic memories are processed through limbic system and stored in hipocampus

143
Q

persistent or recurrent alteration in PERCEPTION OF THE SELF while reality testing remains intact

A

depersonalization disorder

144
Q

reality testing

A

oriented to person, place and time (not hallucinating)

145
Q

depersonalization/derealization disorder is characterized by

A

fell mechanical or dreamy, sense of unreality slow movement, detached from body, may see oneself from a distance or outside of the body, may perceive limbs to be larger or smaller than normal

146
Q

persistent or recurrent experience of UNREALITY OF SURROUNDINGS while reality testing remains intact, often dream like, or disoriented in familiar surroundings

A

derealization

147
Q

an inability to recall important personal information, usually after a severe physical or psychological stressor, too pervasive to be explained by ordinary forgetfulness not due to substance use or neurological or medical condition

A

dissociative amnesia

148
Q

types of dissociative amnesia

A

localized: selective, continuous, generalized

149
Q

inability to recall incidents associated with traumatic events for a specific time period following the event, usually few hours or days, most common

A

localized dissociation amnesia

150
Q

inability to recall only certain incidents associated with traumatic event for a specific period after the event

A

selective dissociation amnesia

151
Q

inability to recall events occurring after a specific time up to and including the present

A

continuous dissociation amnesia

152
Q

not being able to recall anything that happened during the individual entire lifetime, including his/her identity

A

generalized dissociation amnesia

153
Q

behaviors of dissociative amnesia

A

appears alert, clouding of consciousness, often brought to ED by police who find them wondering & confused, onset follows severe psychosocial stress, termination is abrupt followed by full recovery, recurrences are unusual

154
Q

sudden unexpected travel away from the customary locale and inability to recall ones identity and information about some or all of the past

A

dissociative fugue

155
Q

behaviors of a pt with dissociative fugue

A

contacts with others are minimal, assumed identity, don’t behave normally, often picked up by police, present to ED, able to provide details of their earlier life situation but have no recall from the beginning of the fugue state, duration is brief, recovery is rapid & complete, recurrence is not common, excessive alcohol use

156
Q

most severe form of dissociative disorders and formerly known as multiple personality disorder, usually caused by severe psychological trauma (sex abuse)

A

dissociative identity disorder

157
Q

prevalence of dissociative identity disorder

A

90% are women, uncommon

158
Q

features of Dissociative identity disorder

A

alternate identities under stress, existence of at least 2 or more personalities in a single individual, only one personality evident at any given time, each personality (alter) is unique, transition from one alter to another is sudden, usually precipitated by stress, usually not aware of alters

159
Q

if you have a pt that wakes up in a unfamiliar situation with no idea of how they got there, or who people are around them, what disorder might they have

A

dissociative identity disorder

160
Q

what Tx options are available for pts with dissociative identity disorder

A

psychotherapy
hypnosis
creative art therapy

161
Q

enduring patterns of perceiving, r/t and thinking about the environment

A

personality

162
Q

what are the 4 biological humors

A

yellow-bile
black-bile
blood
phlegm

163
Q

yellow bile

A

irritable and hostile

164
Q

black bile

A

pessimistic and melancholic

165
Q

blood

A

overly optimistic and extroverted

166
Q

phlegm

A

apathetic

167
Q

what axis is a personality disorder done on

A

axis 2

168
Q

what are some characteristics of personality disorders

A

have problems with changes, unable to cope with stress, have difficulty responding flexibility and adaptively to the environment and to the changing demands of life, believe they are normal and others have a problem

169
Q

reasons for relationship problems with pts with personality problems

A

blurring of boundaries, inability to trust, avoidance of fear or rejection, passive aggressive traits, have capacity to “get under skin”
Ex. Sam

170
Q

etiology of personality traits

A

environment, genetics, abuse in childhood

171
Q

prevalence

A

between 9-16%

172
Q

Cluster A personality disorders

A

paranoid personality, schizoid personality, schizotypal personality

173
Q

general characteristics of paranoid personality disorders

A

pervasive distrust and suspiciousness of others such that their motives are interpreted as spiteful, beginning in early adulthood and present in a variety of contexts, tense and irritable, notice rank and power

174
Q

prevalence in paranoid personality

A

more common in men, but difficulty to known # bc most don’t seek help with their problem

175
Q

who maintains their self esteem by attributing their shortcomings to others

A

paranoid personality

176
Q

etiology of the paranoid personality

A

environment, defense mechanism, r/t continuum with psychotic disorders such as schizophrenia

177
Q

eccentric, isolated or lonely, profound defect in the ability o form personal relationships or to respond to others in any meaningful, emotional way

A

schizoid personality

178
Q

characteristics of schizoid personality

A

classic loner, doesn’t show much emotion, appear cold or indifferent to others, inappropriately serious about everything, often attached to animals

179
Q

graver from of schizoid personality pattern, once described as “latent schizophrenics”

A

schizotypal personality

180
Q

prevalence of schizotypal

A

common in females, 3% of population

181
Q

characteristics of schizotypal personality

A

bizarre speech pattern, often unkempt, magical thinking, overly superstitious, isolated, excessive social anxiety, may talk to themselves

182
Q

what can happen to a pt with schizotypal personality who is under stress

A

decompensate and demonstrate brief psychotic symptoms (delusional thoughts, hallucinations, bizarre behaviors, magical thinking)

183
Q

etiology of schizotypal personality

A

schizophrenia spectrum and genetically linked, PET scans show structural changes of the brain

184
Q

what structural changes in the brain are seen with schizotypal personalities

A

ventricular enlargement, volume reduction

185
Q

behaviors described as dramatic, emotional, or erratic, pattern of socially irresponsible, exploitative, and guiltless behavior that reflects a general disregard for the rights of others

A

antisocial personality

186
Q

Cluster B disorders

A

antisocial personality
borderline personality
narcissistic personality
histrionic personality

187
Q

characteristics of antisocial personality

A

deceitful, manipulative, absent of remorse for hurting others, without conscious, feel entitled, not responsible for their actions, seductive, can be charming

188
Q

etiology of antisocial personality

A

environment, genetic, often abused as children, as kids they are described as bully, have temper tantrums, don’t respond to punishment, usually have substance abuse problems, cling (see others as all good or all bad)

189
Q

characterized by a pattern of intense and chaotic relationships with affective instability, and fluctuating attitudes toward other people

A

borderline personality

190
Q

prevalence of borderline personality

A

high mortality rate of 10%, extensive use of mental health services, 75% are women and victims of childhood sexual abuse

191
Q

characteristics of borderline personality

A

don’t tolerate being alone, frantic efforts to avoid real or imagined abandonment, cutters, impulsive with sex, spending, substance abuse, show separation anxiety, engage in splitting

192
Q

etiology of borderline personality

A

rapprochement phase: 16-24 months, neg feedback from caregivers, sexual abuse

193
Q

characterized by a persons grandiose sense of personal achievements

A

narcissistic personality

194
Q

characteristics of narcissistic personality

A

consider themselves special, attention seeking, arrogant, takes advantage of others to achieve their goals, blames others for their problems, but they have a fragile self esteem, handle aging poorly

195
Q

characterized by colorful, dramatic, and extroverted behavior, uncomfortable when not center of attention, will manipulate through their dramatic, charming, flamboyant, and sexually seductive behavior, shallow

A

histrionic personality

196
Q

cluster C disorders

A

dependent personality
avoidant personality
obsessive compulsive personality

197
Q

difficulty making everyday decisions without excessive advice and reassurance from others, need others to assume responsibility for most major areas of their life, believe they are incapable of surviving if left alone

A

dependent personality

198
Q

characteristics of dependent personality

A

excessively clinging, self sacrificing, submissive, needy, gets others to care for him or her

199
Q

what do you need to be aware of with dependent personality

A

countertransference

200
Q

extremely sensitive to rejection which may lead to being socially withdrawn, want to be around people, but don’t want to be judged so they withdraw

A

avoidant personality

201
Q

characteristics of avoidant personality

A

avoids activities, unwilling to get involved with people unless certain of being liked, views self as being inferior, high levels of anxiety, most have social phobia, desires social interaction but fear of rejection

202
Q

preoccupied with details, rules, lists, order, organization, or schedules to the point that the purpose of the activity is lost, perfectionist, inflexible, difficulty expressing emotions

A

obsessive compulsive personality

203
Q

what are the most common defense mechanisms for OCD

A

rationalization, reaction formation, isolation, undoing

204
Q

primary gain

A

avoiding

205
Q

secondary gain

A

gaining something

206
Q

terror of gaining weight, less than 85% of expected weight, appear emaciated

A

anorexia nervosa

207
Q

name characteristics of anorexia nervosa

A

preoccupation with thoughts of food, views self as fat even when emaciated, peculiar handling of food, judges self worth by weight, terror of gaining weight, may have compulsive behaviors such as hand washing, may have rigorous exercise regimen, self induced vomit, laxatives

208
Q

clinical presentation of anorexia nervosa

A

cachectic, lanugo, mottled, cool skin, low HR, BP, Temp

209
Q

2 types of anorexia

A

restricting

binge/purging

210
Q

during anorexia nervosa, the person has not regularly engaged in binge eating or purging behavior

A

restricting anorexia

211
Q

has regularly engaged in binge eating or purging behavior

A

binge/purge anorexia

212
Q

complications with anorexia nervosa

A

bradycardia, cardiac murmur, sudden cardiac arrest, leukopenia, , electrolyte imbalance

213
Q

binge and purge, may not physically appear to be ill, often slightly above or below ideal body weight

A

Bulimia nervosa

214
Q

binge eating behaviors

A

food consumed rapidly, usually terminated by self induced vomiting

215
Q

what does self induced vomiting lead to

A

erosion of tooth enamel, dehydration, electrolyte imbalance and gastric/esophageal tears

216
Q

what follows bingeing

A

self degradation and depressed mood

217
Q

clinical presentation of bulimia nervosa

A

normal to slightly low weight, dental caries, tooth erosion, parotid swelling, gastric dilation, calluses on hand, EKG changes

218
Q

Russell’s sign

A

scars on hand from self induced vomiting

219
Q

Bulimia criteria

A

at least twice a week for 3 months

220
Q

regularly engages in self induced vomiting, or the use of laxatives, diuretics, or enemas

A

purging

221
Q

regularly uses fasting or vigorous exercise but does not regularly engage in self educed vomiting, laxative use, diuretics, or enemas

A

nonpurging

222
Q

what treatment is used for bulimia

A

long term cognitive behavioral therapy is most effective, Tx for co-existing depression, substance abuse, personality disorder, individual, group therapy

223
Q

is there a medication specifically for anorexia nervosa

A

no

224
Q

what labs would you do for anorexia nervosa

A

electrolyte, glucose, thyroid function tests, CBC

225
Q

what is the first priority for anorexia nervosa

A

medical stabilization

226
Q

at what % of weight below normal is immediate stabilization needed

A

75%

227
Q

demands of replenished circulatory system overwhelm the capacity of a nutritionally depleted cardiac muscle, which results in cardiovascular collapse

A

refeeding syndrome

228
Q

a single event affects unrelated situations

A

overgeneralization

229
Q

reasoning is absolute and extreme

A

all or nothing thinking

230
Q

the consequences of an event are magnified

A

catastrophizing

231
Q

events are over-interpreted as having personal significance

A

personalization

232
Q

subjective emotions determine reality

A

emotional reasoning

233
Q

prevalence in bulimia nervosa

A

more prevalent than anorexia nervosa, 1.5% in women, 0.5% men, onset is late adolescence, occurs where thinness is emphasized

234
Q

Etiology of eating disorders

A

altered brain serotonin, SSRI increased levels of serotonin do not improve mood sx until after an underweight pt has been restored to 90% of optimal weight

235
Q

are eating disorders issues with food

A

no, based more on serious psychological problems

236
Q

prevalence in anorexia nervosa

A

has increased, 1.0% in women, 0.3% in men, onset occurs early to middle adolescence females

237
Q

enmeshment

A

boundaries between the members are weak, minimal privacy, interactions are intense

238
Q

etiology of eating disorders

A

genetic, psychological (aversion to sexuality), learned behavior, controlling/enmeshment family, environment (western cultural ideal)

239
Q

What medication is effective in relieving pain

A

SNRI’S

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