Human Development MNTH Flashcards
Define unconscious vs preconscious
Unconscious is a reservoir of thoughts and urges outside of conscious awareness
Preconscious are thoughts and feelings that a person is not currently aware of, but which can be easily brought up to the conscious level.
Define Defense Mechanism
Unconscious strategies that people use to protect themselves from anxious thoughts or feelings
Who came up with the idea of Defense Mechanisms, and who continued the work?
Sigmund Freud
Anna Freud considered defense mechanisms as automatisms of the individual. They arise during involuntary and voluntary learning
Bowin 2004: Had the idea that intelligence amplifies emotions, and can keep the psyche focused on repetitive thinking.
Repression
Blocking difficult thoughts from entering the conscious
Regression
Reverting back to the behavior or emotions of an earlier developmental stage when a person is anxious or stressed
Projection
Having a socially unacceptable feeling and instead of facing it, the urge or feeling is seen or projected in the actions of other people.
(That girl is so into me, even when her back is to you)
Reaction Formation
Behaving or expressing the opposite of one’s true feelings
Little man syndrome
Sublimation
Positive Defense Mechanism
Channeling unacceptable urges into a productive outlet
Denial
Refusing to recognize real facts or experiences that would lead to anxiety
Someone with substance abuse thinks they don’t have a problem
Rationalization
Justifying a mistake or problematic feeling with seemingly logical reasons or explanations
Displacement
Redirecting an emotional reaction from the rightful recipient to another “safer” target
Identification with the Aggressor
Taking the role of the aggressor and modeling their attributes, feelings of admiration, gratitude, or identification
Child getting a shot
Stockholm Syndrome
Which part of the brain controls circadian Rhythm?
Suprachiasmatic Nucleus (SCN) Hypothalamic area
Which part of the brain produces melatonin?
Pineal Gland
What is the role of Cortisol in sleep?
Decreases in the first phase of sleep, increases in the early hrs of the morning for wakefulness
Explain the Reticular Activating System’s role in sleep
What is its neurotransmitter
Lesion?
Connects the brain stem to the thalamus to control arousal and alertness
NE
Damage will cause permanent coma
Explain the Raphe Nucleus Role in Sleep
Neurotransmitter
Lesion?
Serotonergic neurons that go through the limbic system and forebrain to start sleep onset
Serotonin
Damage makes it so you can’t fall asleep
Adenosine’s role in sleep?
Increase release w/ activity, it triggers sleep initiation
Caffeine and sleep?
Antagonist of adenosine, makes it hard to get to sleep
Acetylcholine and sleep?
NT for arousal.
Neurons in the dorsal pons and basal forebrain
Important for REM sleep
NE and sleep?
Locus Coeruleus
Produce arousal and sleeplessness
Serotonin and sleep?
Raphe Nuclei
Role is in activating behavior
Histamine and sleep?
Hypothalamic Tuberomammillary Nucleus
Promote and stabilize wakefulness and attention
Orexin and sleep?
Hypothalamus
Involved in wakefulness and arousal
Important in Narcolepsy
Insomnia
Tx?
Unsatisfying sleep quality or quantity w/ 1 or more of the following:
Problem with sleep initiation
Problem with sleep maintenance
Awake 30 minutes before 6.5 hours of sleep
Functional distress
3 nights/wk for 3 months
Standard is non-pharm treatment. Sleep hygiene and therapy
Z-drugs are the 1st line for insomnia
What is the most common of the OTC sleep drug?
Diphenhydramine
Obstructive Sleep Apnea
Tx
Risks: Age over 40, obesity, male
Leads to secondary insomnia
Avoid use of sedatives
Tx: CPAP/BIPAP
Central Sleep Apnea
Tx
Neurologic
Abnormal breathing, awakening, not as much snoring as OSA
Tx:
Reduce Opioids, CPAP
What is Somnambulism
Tx
Sleep walking in non-REM sleep
Tx: Z-drugs NOT recommended increases sleep driving/walking
Nightmare Disorder DSM-5
Tx:
Recurrent well-remembered dreams
Tx: Image Rehearsal Therapy, CBT
Pharm: Prazosin
REM Behavioral Disorder
Tx
Modify sleep environment to decrease sleep injury
Melatonin
Sleep Terrors
Seen in age 3-7, but subside by 10
Dreams in non-REM
No specific Tx
Sleep Paralysis
Tx
Hypnapompic Hallucinations
Trouble getting out of REM sleep
Tx: Pt education, Count down from 20
What are the presumed purposes of sleep?
Conserve Energy
Avoid Predation
Sleeping for restoration
Sleeping for memory
Who wrote about alcohol to demonize it around the time of the revolution?
Benjamin Rush
When was the 18th amendment enforced?
1920-1933
How many Americans abstain from alcohol?
30%
The 10% top drinkers drink more than half of the total alcohol in the US
Who many people have alcohol use disorder and how many people get treatment?
14.4 million 18+ had the disorder. 7.9% got treatment
401,00 ages 12-17 had AUD. 5% got Tx
What is the cause of Wernicke-Korsakoff syndrome
B-12, Thymine deficiency
Causes Dementia and confabulation
Explain the metabolism of alcohol
Steady rate of .25 oz/hr.
LD50 is .40 BAC
Presence of ETOH lowers metabolism of other drugs, and the absence of ETOH increases the metabolism of other drugs. Only in heavy drinkers.
Prochaska and Diclemente (1983)
Trans theoretical Model of Change
6 stages, precontemplation, contemplation, prep, action, main, relapse
Miller and Wilbourne (2003)
Mesa Grande- brief interventions, behavior, marital therapy
Pharmacology: Naltrexone
What is alcohol withdrawal management
No caffeine, multivitamin, oral thiamine
For withdrawal delirium use Benzos
What are medications you can use for alcohol use disorder?
Acamprosate: a-receptor blocker prevents relapse
Disulfuram: Makes you sick to support your abstinence
Oral Naltrexone: Tx for alcohol dependence
Extended injectable Naltrexone
Opioid Antagonists
Naloxone, nalorphine
What are the symptoms of withdrawal symptoms
How are they prevented?
Coma Pinpoint Pupils Respiratory Depression Hypotonia Hypothermia Hyporeflexia
Prevented with opioid agonist.
Withdrawal precipitated sometimes when given naloxone, naltrexone, or buprenorphine
What is the Tx for opioid withdrawal?
- Gradual towering doses of opioid agonists
- methadone (agonist) or buprenorphine (partial agonist) - Use of a2-adrenergic agonists like clonidine
DON’T use anesthesia-assisted Withdrawal Management
Psych Treatment
Contingency Management: Rewards for positive reinforcement for abstinence
CBT
What are opioid overdose Tx:
Explain the contraindications of the medications
Detox or Maintenance
Methadone or Buprenorphine
Methadone: Bugjuice
-used to treat heroin addiction
Contraindications: respiratory depression, increased QT, decreased parastatals
Buprenorphine: mu-partial agonist
Contraindications: hepatitis, current alcohol use, hypovolemia may cause OHTN, and syncope.
