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Nursing 201 > Mental health exam #1 > Flashcards

Mental health exam #1 Flashcards

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1
Q

Therapeutic groups

A

two or more people who develop an interactive relationship and share at least one common goal or issue

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2
Q

Group psychotherapy

A

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

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3
Q

Universality

A

not the only person with the feeling or thought

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4
Q

Altruism

A

boost self concept in a group by helping other people

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5
Q

Instillation of hope

A

see someone has progressed and thinking you can too

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6
Q

imparting of information

A

whoever is in a group saying info to the rest of the group

  • discussion
  • handouts
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7
Q

Corrective recapitulation of the primary family experience

A

in a group setting- group members feel free to talk about problems - try to correct problems- get feedback from others - fix family conflicts that haven’t been resolved - free to express feelings

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8
Q

Development of socializing techniques

A

allowed to communicate their feelings

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9
Q

Imitative behavior

A

role model in a group that has mastered anger and taking after them

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10
Q

Cohesiveness

A

trust, no judgement for how you feel

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11
Q

Existential resolution

A

make decisions, accept responsibility for decisions

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12
Q

Catharsis

A

express positive and negative feelings and feel so much better after doing so

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13
Q

Interpersonal learning

A

learn from each other

-gain insight thru feedback

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14
Q

Support groups

A
  • maintenance groups
  • maintain behaviors
  • helps to reinforce behaviors
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15
Q

Recreational groups

A

Nurse: provide opportunity for fun and relieve tension. Enable pts to experience sense of participation, acceptance, and accomplishment

Ex) in/out sports, field trips, games

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16
Q

Creative expression groups

A

Nurse: facilitate expression of feelings, communication with others, and socialization. Allow for creativity, self-expression, and praise for accomplishments

ex) arts and crafts, ADLs, poetry, art, music, dance

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17
Q

Educational groups

A

for information. Ex) medication knowledge, anxiety, coping, stress management

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18
Q

Goals of family therapy

A
  • understand family dynamics and how they contribute to pts problem
  • look at the family’s strengths and resources - use them
  • looking at the neg. feelings and work on them
  • fam therapy can be used for any type of psychiatric problem
  • usually evident that other fam members also have emotional probs and difficulties
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19
Q

Freud

A
  • first to identify personality development by stages

- 1st five years are most important for basic character development

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20
Q

Conscious

A

material within awareness is only a small part of the mind

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21
Q

preconscious

A

memories that can be recalled with some effort

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22
Q

unconscious

A

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

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23
Q

Id

A
  • source of drives, instincts, needs, genetic inheritance
  • cannot tolerate frustration
  • lacks ability to problem solve
  • “pleasure principle”
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24
Q

Ego

A
  • rational self
  • provides logic and reason
  • problem solver and reality tester
  • strives to maintain harmony
  • “reality principle”
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25
Q

Superego (conscience)

A
  • moral component
  • last to develop
  • concerned with right and wrong
  • opposite of id
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26
Q

Left brain

A

-conscious mind, logic reason, math, reading, analyzing, writing, office of brain. ego.

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27
Q

Right brain

A

-unconscious mind, imagery, creativity, synthesis, dreams, symbols, emotions
id

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28
Q

Compensation (defense mechanism)

A

covering up a perceived weakness by emphasizing a trait one considers more desirable
ex) short person = good businessman

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29
Q

Denial (defense mechanism)

A

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

ex) death of someone – saying “no, I don’t believe you.”

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30
Q

Displacement (defense mechanism)

A

transfer of feelings to another that is considered less threatening or neutral
ex) pt criticizes RN for family not visiting

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31
Q

Identification (defense mechanism)

A

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

ex) 8 year old dresses up like the teacher

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32
Q

Intellectualization (defense mechanism)

A

An attempt to avoid expressing emotions related to a stressful situation by using intellectual process of logic, reasoning, and analysis
ex) farmer lost farm and hides anxiety by analyzing options and getting child to safety

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33
Q

Projection (defense mechanism)

A

Attribute feelings or impulses unacceptable to one’s self to another person
ex) man attracted to another woman and teases wife about flirting with other men

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34
Q

Rationalization (defense mechanism)

A

Attempting to make an excuse or formulate logical reasons to justify unacceptable feelings or behaviors
ex) didn’t get a raise bc the boss doesn’t like you

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35
Q

Reaction formation (defense mechanism)

A

Preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behaviors

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36
Q

Regression (defense mechanism)

A

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

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37
Q

Repression (defense mechanism)

A

Involuntary blocking unpleasant feelings and experiences from one’s awareness
ex) man forgets wife’s bday after martial fight

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38
Q

Sublimation (defense mechanism)

A

Re-channeling of drives and impulses that are personally or socially unacceptable into activities that are constructive

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39
Q

Suppression (defense mechanism)

A

Voluntary blocking of unpleasant feelings and experiences from one’s awareness

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40
Q

Undoing (defense mechanism)

A

Symbolically negating or canceling out an experience that one finds intolerable
ex) Nervous about new job and yells at wife - then goes to buy her flowers

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41
Q

Isolation (defense mechanism)

A

Separating a thought or memory from the feelings, tone, or emotions associated with it
ex) not showing emotion when talking about being raped

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42
Q

Freud’s theory

A

Explanation of human processes. Formation of the personality is rooted in past events. Experiences during early stages determine lifetime adjustments

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43
Q

Anxiety

A
  • part of living. The ego develops defense mechanisms by preventing conscious awareness of threatening feelings
  • most work on an unconscious level (except suppression)
  • we cannot survive without these def. mech.
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44
Q

Erikson’s theory

A
  • emphasis placed on stages of development
  • each stage is an emotional crisis
  • the degree of mastery is related to the degree of maturity that the adult achieves
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45
Q

Frontal lobe

A

Associated with reasoning, planning, parts of speech, movement, emotions, and problem solving

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46
Q

Parietal Lobe

A

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

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47
Q

Occipital Lobe

A

Associated with visual processing

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48
Q

Temporal Lobe

A

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

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49
Q

Limbic system

A
  • the “emotional brain”
  • regulates emotion and memory
  • influences motivation, mood, and sensations of pain and pleasure
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50
Q

Acetylcholine

A

involved in voluntary movement, learning, memory, and sleep.

-too much is associated with depression, and too little in the hippocampus has been associated with dementia

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51
Q

Dopamine

A
  • correlated with movement, attention, and learning
  • too much has been associated with schizophrenia, and too little is associated with some forms of depression as well as the muscular rigidity and tremors found in parkinsons
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52
Q

Norepinephrine

A
  • associated with eating and alertness

- too little norepinephrine has been associated with depression, while an excess has been associated with schizophrenia

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53
Q

Epinephrine

A
  • involved in energy and glucose metabolism

- too little epinephrine has been associated with depression

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54
Q

Serotonin

A
  • plays a role in mood, sleep, appetite, and impulsive and aggressive behavior.
  • too little is associated with depression and some anxiety disorders, especially obsessive compulsive disorder
  • some anti-depressant meds increase the availability of serotonin at the receptor sites
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55
Q

GABA

A
  • inhibits excitation and anxiety
  • too little is associated with anxiety and anxiety disorders. some anti-anxiety meds increase GABA at the receptor sites
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56
Q

Endorphins

A

-involved in pain relief and feelings of pleasure and contentedness

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57
Q

Hildegard E. Peplau

A

established the framework for the interpersonal development of the nurse with the patient

58
Q

Key concepts of Peplau

A
  • human relationship btwn RN and person who is ill
  • relationship helps us to understand pts behavior and vice versa
  • RN accepts pt as they are but acts as resource for pt and a teacher – help to get better
59
Q

Voluntary patients

A
  • pt or guardian applies for tx

- pt or guardian can sign out of tx

60
Q

Involuntary commitment

A
  • mental illness is not synonymous with incompetence
  • pt who is legally competent to request tx but refuse to do so
  • state must prove mentally ill and dangerous
61
Q

Evaluation and emergency care

A
  • 72 hours

- those who are dangerous to self or others or gravely disabled

62
Q

Certification for observation and treatment

A
  • short term observation and treatment
  • 14 days
  • psychiatrist in 24 hrs
  • disorder must be treatable
  • probable cause required by 4th amendment
63
Q

Extended or indeterminate commitment

A
  • long term
  • Need prolonged care but refuse, voluntary
  • 3,6,12 months
  • requires a court hearing
64
Q

Patient Rights

A
  • tx in least restrictive environment
  • confidentiality
  • freedom from restraint and seclusion
  • refuse tx
  • suspension of rights
65
Q

Hospital-based care

A
  • short term
  • crisis intervention and safety
  • d/c planning
  • psychotherapeutic management model
66
Q

Outpatient services

A
  • mental health clinics
  • private practices
  • primarily for counseling
67
Q

Partial programs

A
  • structured activity and tx during the day

- pt returns home in evening

68
Q

Residential services

A
  • extended care facilities
  • group homes
  • halfway houses
  • apartment living programs
69
Q

Complementary therapies

A
  • a broad range of healing philosophies, approaches, and therapies
  • used alone or in combo with conventional therapies
    ex) st. johns wort
70
Q

Post-traumatic stress disorder

A
  • persistent re-experiencing of a highly traumatic event that involved actual or threatened death or serious injury to self or others
  • person responds with intense fear, helplessness
  • PTSD may occur after any traumatic event that is outside the range of usual experience
  • symptoms begin within 3 mo. of trauma
71
Q

Diagnostic criteria for PTSD

A
  • exposure
  • presence of one or more symptoms
  • persistent avoidance of stimuli associated with trauma
72
Q

PTSD has the presence of one or more of the following symptoms…

A
  • recurrent, involuntary, and intrusive distressing memories of the traumatic event
  • recurrent distressing dreams in which the content and/or the effect of the dream is related to the traumatic even
  • dissociative reactions (flashback) in which that individual feels or acts as if the traumatic event is occurring
73
Q

PTSD - persistant avoidance of stimuli associated with the trauma

A

-causes the individual to avoid talking about the even or avoid activities, people, or places that arouse the memory of the trauma

74
Q

Negative alterations in cognitions and mood associated with the traumatic event such as…

A
  • inability to remember an important aspect of the event
  • blaming self or others
  • diminished interest in activities
  • persistant negative or emotional state
  • feeling detached or estranged from others
  • inability to experience positive emotions
  • persistent feelings of increased arousal, trouble sleeping, concentrating, exaggerated startle response
75
Q

PTSD people have difficulties in…

A
  • relationships: interpersonal, occupational, social
  • trust: common issue of concern
  • child or spouse: abuse may be associated with hyper-vigilance and irritability
  • chemical abuse: to self medicate to relieve anxiety
76
Q

Acute Stress disorder

A
  • occurs within 1 month after exposure to a highly traumatic event, such as PTSD
  • must display 3 dissociative symptoms either during or after the traumatic event

Dissociation:

  • subjective sense of numbing or detachment
  • reduced in awareness of surroundings (in a daze)
  • derealization (sense of unreality to environment)
  • depersonalization (feeling alienated)
  • dissociative amnesia (inability to recall important personal info)

will resolve in 4 weeks if not PTSD

77
Q

Anxiety disorders

A
  • a feeling tone of anticipation, generally unpleasant

- normal anxiety = healthy rxn for survival

78
Q

Defense mechanisms for anxiety

A
  • primary method that the ego uses to control or manage anxiety
  • will decrease anxiety
  • consistent use (as opposed to prob solving) is not emotionally healthy
79
Q

Prevalence of anxiety

A
  • common emotion
  • Normal response to threatening situation either real or perceived
  • conscious attempts to protect self - coping behaviors
  • most common for of psychiatric disorder
  • 28.8% of adult population
  • women are affected more than men
  • comorbidity
80
Q

Etiology of anxiety

A
  • genetic: anxiety disorders tend to cluster in families
  • Limbic system: appraise emotional stimuli, initiate an emotional response, return to homeostasis
  • GABA: primary inhibitory neurotransmitter in the brain, function to regulate the output of excitatory neurotrans, increased GABA is often observed in response to elevated excitatory activity, high GABA levels in the presence of high excitatory activity are associated with sleep issues, nervousness, anxiousness and panic attacks
  • Decreased levels of serotonin
81
Q

Behavioral/cognitive - anxiety

A
  • anxiety is a learned response
  • generalized from earlier traumatic experiences to a benign setting or object
  • anxiety occurs when an individual encounters a signal that predicts a painful and feared response
  • Normal anxiety disappears when the danger or stressor is gone
  • abnormal anxiety remains when the stressor is no longer present causing a disruption
82
Q

Panic attacks

A
  • sudden onset
  • accompanied by intense fear and impending doom
  • feeling of terror
  • cannot function normally
  • “out of the blue”
  • fear of losing control - “going crazy” , “heart attack”
  • lasts just minutes and then subsides
  • perceptual field is limited
  • misinterpretation of reality may occur
  • personality disorganization is evident
83
Q

S/S of a panic attack

A
  • palpitations
  • chest pain
  • breathing difficulties
  • nausea
  • feeling of choking
  • chills
  • hot flashes
84
Q

Panic attacks with Agoraphobia

A
  • intense, excessive anxiety or fear about being in places or situations
  • from which escape might be difficult or embarrassing
  • or in which help may not be available if a panic attack occurs
  • can be debilitating and life constricting

examples:

  • being alone outside
  • being alone at home
  • traveling by car, bus airplane
  • being on a bridge
  • riding in an elevator
85
Q

Phobias

A
  • irrational fear of an object or situation that persists although the person may recognize it as unreasonable
  • specific phobia
  • avoid activity, object, etc
86
Q

Obsessive Compulsive disorder

A
  • obsessions and compulsions can exist independently but often occur together
  • cause increase in stress - time consuming
  • Obsession: thoughts, impulses, or images that persist and recur so that they cannot be dismissed from the mind. Seems senseless to the person, extreme anxiety
  • Compulsion: ritualistic behaviors an individual feels compelled to perform to reduce anxiety, performing the compulsive act temporarily reduces the anxiety
87
Q

DSM-5 criteria for OCD

A

1) obsession or compulsion: a) preoccupation with persistant or intrusive thought, impulses, or images. b) repetitive behaviors or mental acts where the person feels driven to perform in order to reduce distress or anxiety tp prevent a dreaded event or situation
2) knows obsession or compulsions are obsessive and unreasonable
3) obsession compulsions cause increase in distress and are time consuming

88
Q

Types of obsessions and related compulsions

A
  • doubt, need to check if door is locked, appliances off

- need for order - need to have objects in a fixed and symmetrical position

89
Q

Hoarding

A
  • excessive collecting of items
  • failure to discard excessive amounts of these items
  • is associated with OCD
  • usually have poor coping abilities
  • Effects: can be disabling, social isolation, disruption of daily living, often live in unsafe conditions
90
Q

Symptoms of Generalized Anxiety disorder

A
  • excessive worry and anxiety about numerous things, lasting for 6 months or longer
  • the anxiety is out of proportion to the true impact of the event or situation
  • inadequacy in interpersonal relationships
  • job responsibilities
  • finances
  • health of family members
  • household chores, lateness for appointments
91
Q

DSM-5 criteria for Generalized anxiety disorder

A
  • excessive worry and anxiety more days than not for 6 mo.
  • inability to control the worrying
  • anxiety and worry are associated with 3 or more of the symptoms
  • anxiety and worry and physical disturbance cause significant impairment to social, occupational or other areas of important functioning
92
Q

Substance-induced anxiety disorder

A
  • need to determine substance involves
  • anxiety, panic attacks, obsessions and compulsions that develop with use of substance or within a month of stopping use of substance
93
Q

Anxiety Disorder Not Otherwise Specifies (NOS)

A

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

94
Q

General Assessment of anxiety

A
  • not hospitalized
  • seen in a variety of community settings
  • determine if anxiety related to secondary source like a substance or medical condition
  • think about symptoms, rule things out
95
Q

Interventions for anxiety disorders

A
  • provide safe, calm environment, decrease stimuli, listen to and reassure pt that they are in control
  • encourage pt to talk about feelings and concerns
  • reframe the problem in a way that is solvable, provide a new perspective and correct distorted perceptions
  • identify thoughts or feelings prior to the onset of anxiety
  • if hyperventilation occurs instruct pt to take slow, deep breaths, breathing w/ pt may be helpful
  • ask pt to identify what and how they feel
  • help pts identify possible causes of their feelings
  • involve pts in activities such as going for a walk
  • teach pts relaxation techniques - promote use of hobbies or rec. activities
96
Q

Anti-depressants

A

SSRIs & SSNRIs

  • take 4-6 weeks to realize full benefit
  • do not stop abruptly (discontinuation syndrome)
  • do not use with etoh
97
Q

SSRIs

A

serotonin reuptake inhibitors are that first line of tx for panic disorders

  • start out on low dose to see how pt does
  • bipolar pts may go maninc after new anti-depress.
  • ex) paxil, prozac, zoloft
98
Q

SSNRIs

A

serotonin norepinephrine reuptake inhibitors

-cymbalta, effexor

99
Q

Benzodiazepines

A

-used on a short term basis when a quick-acting medication is needed
-used SHORT TERM due to potential dependence
-SE: slow you down, sedation, ataxia
-Action: potentiate the effects of GABA and decrease excitability, produces a calmative effect, all levels of CNS depression can be affected from mild sedation to hypnosis to coma
-Dependence: need to take drug to behave normally, when removed body doesn’t like and act abnormal, dependent within weeks
-Withdrawal: anxious, irritable, insomnia, gradual taper
-Tolerance: need more to get same effect
-Overdose: somnolence, confusion, coma, reflexes and BP decreased
DO NOT: increase dose or freq, drink etoh, breastfeed, drink with caffeine, take if preg., stop abruptly
-xanax, valium, klonopin, ativan

100
Q

Beta-blockers

A
  • propranolol
  • for GAD and panic disorder
  • blocks beta-adrenergic receptors in the sympathetic nervous system causing a relaxation response
101
Q

BuSpar

A

-does not cause dependence
-need 2-4 weeks to reach full effect
-used for long term treatment
-should be taken regularly
SE: HA, dizzy, light headed, nausea, insomnia

102
Q

Somatoform disorders

A
  • convert anxiety into a physical symptom for which there is no identifiable physical diagnosis
  • not intentional or under the control of the pt
  • physical symptoms for which there is no organic cause
103
Q

Characteristics of somatoform disorders

A
  • do not see themselves as having a psychiatric problem
  • do not seek tx from a psychiatrist
  • historically hysterical neurosis
  • freud-unexpressed emotion convert to physical symptoms
104
Q

S/S of Somatoform disorders

A
  • obsessively interested in bodily process and diseases
  • attention is focused on the discomfort
  • aware of the small changes that would go unnoticed in others
  • resistant to assistance
  • info, education, explanation temporarily lessen fear
  • do suffer
  • nursing relationship - good rapport with these pts
  • doctor shop
105
Q

Etiology of Somatoform

A
  • no direct evidence of genetic etiology but support showing that it tends to run in families
  • psychoanalytic: c/o pain, can’t function, don’t feel good, conflict with anxiety, come out as physical symptom
  • behavioral: helpless bc can’t communicate needs, want people to feel bad for them
  • cognitive: the patient with somatoform symptoms focuses on body sensations, misinterprets their meaning, and then become excessively alarmed by them
106
Q

Factitious Disorder (artificial or contrived)

A
  • intentionally produce physical pr psychologic s/s to assume sick role
  • NO INTENT FOR ECONOMIC GAIN (just attention)
107
Q

Munchausen syndrome

A

the most severe form and can result in hospitalization; doctor shopping in attempts to seek surgery and invasive diagnostic tests

108
Q

Malingering

A
  • involves a conscious process of intentionally producing symptoms FOR ECONOMIC GAIN.
  • symptoms are usually highly subjective and difficult to prove or disprove (back pain, HA)
  • often attempting to obtain pain meds, disability benefits or monetary gain from a lawsuit against an employer
109
Q

Somatization disorder

A
  • most common somatoform disorder
  • symptoms are vague dramatized or exaggerated
  • multiple somatic complaints that cannot be explained
  • symptoms can be chronic and relapsing
  • may threat suicide- methods not lethal tho
  • more often female
110
Q

Somatization disorder feature and symptoms

A
  • strong dependency needs
  • preoccupation with symptoms and oneself
  • heightened emotionality
    symptoms: pain (back, neck), GI (NVD), sexual symptoms (irreg. menses, ED), neurological (paralysis, blindness, deafness)
111
Q

Pain disorder

A
  • pain anywhere - which causes them impairment (can’t work, etc)
  • freq. go to doc
  • looking for pain meds
  • even have unnecessary surgery
  • have real pain
  • no organic cause - no pathology involved
112
Q

Hypochondriasis

A
  • results in misinterpretation of innocent sensations as evidence of a serious illness
  • unrealistic or inaccurate interpretation of physical symptoms or sensations
  • have overwhelming overconcern for their health (become preoccupied with any symptoms)
  • extreme worry and fear
  • if you suggest it’s nothing etc. or tell them to see mental health prof. - they refuse and think concerns are legit
  • chronic and relapsing
  • symptoms become worse when they have more stress in their life (go from doc to doc constantly)
  • if they read or hear about a disease and think they have it
113
Q

Conversion disorder

A
  • the presence of deficits in voluntary motor or sensory functions, including paralysis, blindness, movement disorder, gait disorder, numbness, loss of vision
  • “pseudoneurological” - paralysis, aphonia, seizures, anosimia
114
Q

La belle indifference (conversion disorder)

A

show lack of emotional concern about the symptoms

  • loss or change in body function
  • resulting from physiological conflict
  • physical symptoms can’t be explained by a medical disorder
  • unable to control their symptoms
115
Q

Body dysmorphic disorder

A
  • characterized by the exaggerated belief that the body is deformed or defective in some specific way
  • commonly involve: face/head, nose, ears, mouth, lips, teeth
  • person’s concern is grossly excessive
  • depression and obsessive-compulsive personality are common
  • med hx: visits to plastic surgeons and dermatologists to correct the imagined defect
  • feel shame or worthlessness
  • women: face, men: genitalia, build
116
Q

KEY POINT of somatoform disorders

A

in somatoform disorders symptoms are not intentional or under the conscious control of the patient, unlike malingering or factitious disorder

117
Q

Secondary gain

A

gaining attention or support not otherwise forthcoming

118
Q

Primary gain

A

the conversion symptoms enable the person to avoid difficult situations or unpleasant activities about which he or she is anxious
-don’t want to give speech so you stay home: prim gain= don’t have to do it. secondary gain= extra attention from staying home “sick”

119
Q

Dissociation

A

an unconscious defense mechanism to protect the individual against overwhelming anxiety
-they have intact reality testing

120
Q

Depersonalization/Derealization disorder

A
  • depersonalization: temporary change in quality of self-awareness which often take the form of
  • feelings of unreality (things don’t seem right, hazey, dream-like state)
  • changes in body image
  • feelings of detachment from environment
  • sense of observing oneself from outside body
  • derealization: an alteration in the perception of the external environment (you know where you are but seems hazey/dream-like, more related to environment)
121
Q

Key concept of dereal/deperson.

A

in both, symptoms cause clinically significant distress of impairment in social, occupational or other important area of functioning

122
Q

S/S of depersonalization/derealization disorder

A
  • a mechanical or dream-like feeling
  • a belief that the body’s physical characteristics have changed
  • may perceive limbs to be larger or smaller than normal
  • objects in the environment are perceived as altered in size and shape
  • other people may seem automated or mechanical
  • younger ppl and women
123
Q

Dissociative Amnesia

A

inability to recall important personal information, usually after severe physical or psychological stressor

124
Q

Localized dissociative amnesia

A
  • inability to recall all incidents associated with the traumatic event for a specific time period following an event
  • usually a few hours to a few days
125
Q

Selective dissociative amnesia

A

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

126
Q

Generalized dissociative amnesia

A

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

127
Q

Continuous dissociative amnesia

A

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

128
Q

Behaviors of dissociative amnesia

A
  • appear alert
  • brief disorganization or clouding of consciousness
  • often brought to the ED by police who find them wandering or confused
  • ONSET FOLLOWING SEVERE PSYCHOSOCIAL STRESS
  • termination is abrupt followed by full recovery
  • recurrences are unusual
129
Q

Characterized by dissociative fugue

A
  • sudden, unexpected travel away from the customary locale and inability to recall one’s identity and information about some or all of the part
  • rare, may assume new identity
130
Q

S/S of dissociative fugue

A
  • do not appear to be behaving abnormally
  • contacts with others are minimal
  • the assumed identity may be simple and incomplete or complex and elaborate
  • often picked up by the police when they are found wandering in a confused and frightened condition after emerging from the fugue in unfamiliar surroundings
  • can be presented to ED
  • able to provide details of their earlier life situation but have no recall from beginning of fugue state
  • info from other sources usually indicates severe psychological stress or excessive alcohol use predicted the fugue behavior
  • duration is brief
  • rapid recovery and complete
  • recurrence not common
131
Q

Dissociative identity disorder

A
  • most severe form of depressive disorders and formerly known as multiple personality disorder
  • each personality (alter) is unique and composed of a complex set of memories behavior patterns and social relationships that surface during that interval
  • transition from one personality is usually sudden, often dramatic and usually precipitated by stress
  • various theories; severe psychological trauma
  • before therapy, original personality usually has no knowledge of the other personalities
  • however when there are two or more subpersonalities they are usually aware of each other’s existence
  • subpersonalization have different names, race,sex, age
  • usually there is amnesia for the events that took place when another personality was in the dominant position and may report gaps in history of event
  • may “wake up” in unfamiliar situations with no idea how they got there or who the people are around them
  • accused of lying when they deny remembering or being responsible to events or actions that occurred while another personality controlled the body
    tx: psychotherapy, hypnosis, creative art therapy
132
Q

Cluster A

A

odd or eccentric

133
Q

Cluster A: paranoid personality

A
  • pervasive distrust and suspiciousness of others that their motives are interpreted as spiteful, beginning early adulthood and present in a variety of contexts
  • constantly on guard
  • tense, irritable
  • insensitive to feelings of others
  • suspects others are exploiting, harming, deceiving them
  • doubts loyalty of friends or associates
  • have intimidating manner
  • hidden meaning to behign remarks
  • do not accept responsibility for behavior
  • envious and hostile towards others
134
Q

Cluster A: schizoid personality

A
  • profound defect in the ability to form relationships or to respond to others in any meaningful, emotional way
  • appear cold, aloof, isolated, lonely, unsociable
  • avoid relationships, little desire for emotional ties
  • shy, anxious, uneasy, day-dream, attachment to animals
  • unable to experience pleasure
135
Q

Cluster A: schizotypal personality

A
  • a graver form of schizoid personality
  • aloof, isolated, behave in bland and apathetic manner
  • bizarre speech pattern
  • cannot orient their thoughts logically and can become lost in irrelevant
  • often unkempt, respond inappropriately to social cues
  • excessive social anxiety, avoid interpersonal relationships
  • under stress: de-compensate and demonstrate brief psychotic symptoms, delusional thoughts, hallucinations, bizarre behaviors, magical thinking
136
Q

Cluster B: Antisocial personality

A

socially irresponsible, exploitative and guiltless behavior that reflects a GENERAL DISREGARD FOR THE RIGHTS OF OTHERS.

  • ABSENT OF REMORSE FOR HURTING OTHERS
  • can be charming, manipulative, aggressive, seductive, lies, deceitful
137
Q

Cluster B: Borderline personality

A
  • intense and chaotic relationships with affective instability and fluctuating toward other people
  • severe impairments in functioning
  • high mortality rate of 10%
  • extensive use of mental health facilities
  • frantic effort to avoid real or imagined abandonment
  • pattern of unstable and intense interpersonal relationships
  • recurrent suicidal behavior, threats or self-mutilating behavior
  • engages in splitting, impulsive, separation anxiety, emotional lability
138
Q

Cluster B: Narcissistic personality

A
  • person’s grandiose sense of personal achievements
  • arrogant and conceited and has a sense of entitlement
  • lack of empathy for the feelings of others
  • requires excessive admiration
  • take advantage of others to achieve own needs
  • will blame others for their problems they themselves caused
  • often envious of other’s success or possessions
  • prone to depression
  • tantrums, manipulative, arrogant, filled with rage, sensitive to rejection, handles aging poorly
139
Q

Cluster C: dependent personality

A
  • anxious and fearful
  • difficulty making everyday decisions without excessive advice and reassurance
  • believe they are incapable of surviving if left alone
  • excessive need to be taken care of
  • have difficulty expressing disagreement with others
  • excessive clinging, submissive, needy
140
Q

Cluster C: avoidant personality

A
  • extremely sensitive to rejection which may lead to being socially withdrawn
  • unwilling to get involved with people unless certain of being liked
  • high levels of anxiety
  • low self-worth
  • may have social phobias
  • preoccupied with being criticized or rejected
141
Q

Cluster C: Obsessive compulsive personality

A
  • preoccupies with details, rules, lists, order organization or schedules to the point that the purpose of the activity is lost
  • perfectionist, devoted to work
  • very serious and formal and have difficulty expressing emotions
  • intense fear of making decisions
  • inflexible about way things should be done
  • need for control
  • highly critical of self and others

Nursing 201 (6 decks)

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