finalllllll Flashcards
Somatic symptom disorder/anxiety illness disorder
Excessive thoughts, feelings, or behaviors related to somatic symptoms including: persistent thoughts about the seriousness of the symptoms, persistent anxiety about the symptoms, excessive time and energy focused on the symptoms.
How many months must somatic symptom disorder be present for?
at least 6 months
Comordities of somatic somatic/anxiety illness
depression, anxiety, panic disorder “DAP”
Somatic/illness implication for function
Mild to moderate in most cases, work deficits with absenteeism, distraction as a result of worry, may be cognitive and emotional regulation deficits, and issue with self identity and self image
Conversion disorder
one or more symptoms of altered motor function (weakness, paralyzed, slurred speech, swallowing issues) or sensory function (visual, olfactory, auditory)
Psychological factors affecting medical conditions
of somatic/illness
- presence of a medical symptom or condition other than a mental disorder.
- Psychological or behavioral factors affect the medical condition: affect the course of the medical condition, interfere with treatment of the medical condition, increase health risk for the person, and influence the pathophysiology, cause, exacerbation of the disorder or the need for medical treatment.
- Diagnostic category used for situations where medical condition (cancer) is associated with depression or anxiety.
- Need to address psychological symptoms to improve medical outcomes and quality of life.
Somatic/illness lifespan considerations
- n children, somatic symptoms may be expression of anxiety
- Children with somatic symptoms are likely to have dysfunctional educational experiences (school absence) and involved in the juvenile justice and welfare systems
- In later life, somatic symptoms often express anxiety or depression
- May present in later life with some degree of cognitive confusion
Pica - diagnostic criteria
persistently eating non food items
to be diagnosed with pica, u have to show symptoms for at least?
1 month
Pica Comorbitities (Alvina Ingests Socks)
autism, intellectual and schizophrenia
Pica OT implications
Self-care associated with cooking/eating always affected Physical health (malnutrition, intestinal blockage, toxin), cognitive function and processing
Ot behavioral intervention
Establish strategies with positive direction/ outcome
Focus on providing other occupations, meal preparation
Environmental modifications
Anorexia Nervosa DC
Restriction of caloric intake leading to significant low body weight
Intense fear of gaining weight or being fat
Disturbance in body image, excessive concern about body weight or shape, or lack of recognition of the seriousness of the current low body weight
Comorbidities Anorexia
depression and anxiety
Anorexia treatment
Medical management to address nutritional deficits
Psychodynamic therapy- control issues
CBT
Nontraditional antipsychotic medications- address dopamine dysfunction
Combination probably most effective
Anorexia OT implication
Occupational engagement
Therapeutic alliance- a cooperative working relationship between client and therapist; goal setting
Focus on acceptable leisure pursuits that de-emphasize food
Social skills training
Stress management; Self-expression opportunity
Support and education for caregivers and families
Bulemia DC
Repeated episodes of binge eating
Inappropriate mechanisms for compensating for overeating (vomiting, laxatives)
Binging and purging
Self-image is not excessively influenced by bodyweight
Bulemia DC how long
At least once a week for 3 months
DCT (dialetctical behavior therapy) treatment _____ and used in _____
focuses on awareness of problems and choices, mood regulation techniques, and coping skills”
Invalidating environment:
bulemia
Invalidating enviroment
- bulemia
- “its tendency to respond inappropriately to private experiences independent of the validity of the actual behavior”
- The environments create a sense of uncertainty, unpredictability, or hostility
Bulemia OT implications
Coping skills training focused on mood regulation, managing social situations, and interaction with the environment
Practice avoiding triggering situations
Meaningful occupations that reduce urge to binge (e.g. yoga)
Binge Disorder DC
Repeated episodes of binge eating: in a limited time, eats an amount much larger than is considered normal; lacks control over eating during each episode
The episodes are associated with: eating too quickly, eating until uncomfortable, eating large amounts when not hungry, eating alone because of guilt or depression, feeling disgusted with oneself, distress about binge eating.
Not associated with anorexia or bulimia
Binge Disorder DC Length
Average once a week for at least 3 months
Binge Disorder treatment
Integrative response therapy, a group-based guided self-help treatment focused on affect regulation.
Cognitive behavioral therapy with accompanying medication
Medication
Binge Implications for OT
Wellness efforts focused on changing behaviors
Emphasis on healthy occupations that address eating habits
Health promotion/prevention activities with children
Eating Disorders lifespan considerations
Pica and rumination disorder occur primarily in children
Anorexia and bulimia most often emerge in adolescence. Consider family therapy
For older adults, physiological regulation of appetite changes
Changes in neurotransmitter production often cause decrease in appetite in older adults which can lead to malnutrition
Anorexia of aging is qualitatively different from that of younger adults because it Is not typically associated with conscious choice
Encropese DC
once a month 3 months, 4 years
Insomnia DC
Dissatisfaction with quality or amount of sleep:
Difficulty falling asleep
Difficulty maintaining sleep (frequent waking)
Early morning waking
*At least three nights a week For at least three months
In spite of adequate opportunities for sleep
Distress or dysfunction
Insomnia Comorbidities
Anxiety, Trauma, Depression
Narcolepsy DC
Repeated intense need to sleep, falling asleep, or napping within the same day.
At least three times per week for at least three months
At least one of:
Cataplexy at least a few times per month:
Brief episodes of sudden loss of muscle tone triggered by sudden, strong emotions- laughing/ joking, fear, anger or excitement while remaining conscious [a cat that has low tone]
Spontaneous grimaces or global hypotonia
Hypocretin deficiency- regulate sleep and energy
Rapid eye movement (REM) sleep less than 15 minutes
Obstructive Sleep Apnea DC
One of the following:
Polysomnography of at least 5 obstructive apneas or hypopneas per hour of sleep with:
Nighttime breathing disturbances like snoring or breathing pauses during sleep
Daytime sleepiness or fatigue in spite of adequate opportunities for sleep
Or 15 or more episodes of apnea (no breathing @ all) or hypopneas (abnormally slow breaths) per hour of sleep without other symptoms
Obstructive Sleep Apnea Etiology
Facial structure (shape of jaw, nasal septum) & amount of upper airway soft tissues Overweight or obesity
Circadian Rythym Disorder DC
Sleep disruption due to alteration of circadian system or a mismatch between the person’s rhythm and the requirements of the social or work environment
Excessive sleepiness or insomnia or both
Distress or dysfunction
Circardian Rythym Disorder Etiology
Degeneration or decreased neuronal activity of suprachiasmatic nucleus neurons (melatonin)
Decreased responsiveness of the body’s internal clock to signals such as light and activity
Decreased exposure to bright light and structured social and physical activity during the day
These may occur as a result of shift work or jet lag
Sleep Cycle Stage 1
Entering sleep, light (1-7 minutes)
Sleep Cycle Stage 2
Light sleep, heartbeat and breathing starts to slow down, muscles start to relax (10-60 minutes)
Sleep Cycle Stage 3
Deep sleep, more slow and relaxed (20-40 minutes)
Sleep Cycle Stage 4
REM- Increase brain activity, increase heart rate & BP, dreams, muscles paralyzed (10-60 minutes)
