Midterm Flashcards
The first 6 weeks
What are 2 main criteria that are used to determine that a person’s behavior, emotions, or experiences constitute a mental disorder?
statistically atypical
functional impairment
subjective distress
What are some concerns of diagnostic labels?
Stigma
Label can overshadow person’s identity
Diagnosis may disqualify someone from an employment role, etc.
Misdiagnosis = causes harm/damage
What are some benefits of diagnostic labels?
Access to empirically-supported treatment/treatment planning
Access to disability benefits/insurance benefits
Aids in understanding of symptoms
What is meant by the “presenting problem”?
The presenting problem is the reason why the client is seeking therapy. This includes the client’s conflicts or stressors, level of insight or denial, and aspects of mental status such as mood, behavior, and thought processes.
After the client describes the presenting concern (e.g.,anxiety), why is it helpful to ask “what does anxiety mean to you?” and/or “what do you experience when you are anxious?”
The answers can reveal culture-specific interpretations of the symptoms and experiences. Never assume your definition of the problem is the same as the client’s definition. Always ask for clarification, even for such common diagnostic labels as depression and anxiety, especially when the client is different from you (Cozolino, 2004). Failure to consider the client’s conceptualization of his or her problems may result in nonad herence to recommended treatments and/or premature termination from therapy.
As non-medical therapists, why do we need to know about a person’s medical/health state? Is it really possible for medical conditions or substances/medications to mimic or trigger psychiatric symptoms?
Knowledge of a client’s currenthealth status provides information on potential stressors he or she is facing. In addition,some medical conditions can cause symptoms that mimic psychiatric conditions (e.g.,hypothyroidism can mimic symptoms of depression, including anhedonia, forgetfulness,diminished concentration, low energy, and sleep disturbance).; yes!
What does the acronym ‘CLIENT’ stand for in intake interviewing?
C - Cause (what client thinks caused the problem)
L - Length (duration of onset and when it became chronic)
I - Impairment (areas of client’s life that are being impacted)
E - Emotional impact
N - Noticed (have others noticed changes in client)
T - Tried (what has the client tried to alleviate the problem)
What is FIDO?
Frequency, Intensity, Duration, and Onset
During an intake, is it appropriate to ask if the client has discussed his/her symptoms with a physician?
Yes and this question needs to be asked!
Note how cultural identity can impact a person’s understanding of the presenting problem, what itmeans to seek therapy services, and the client-therapist relationship?
The individual’s and family’s connection to a cultural group and level of assimilation may highlight the availability of support and a sense of cultural identity. Additionally, the attitude of family members to treatment and their level of involvement in the individual’s life may guide later interventions.
There are many other answers to this question. You know them all, so just rely on your knowledge!
What is the Cultural Formulation Interview (CFI)?
A set of protocols that clinicians may use to obtain information during a mental health assessment about the impact of culture on key aspects of an individual’s clinical presenetation and care.
What is meant by “person-centered approach” in intake interviewing? What is this approach designed to do?
Eliciting information from the individual about his or her own views and those of others in his or her social network. This approach is designed to avoid stereotyping.
What are some reasons that cultural concepts are important to consider with psychiatric diagnosis and
treatment.
- Avoid misdiagnosis based upon cultural misunderstandings
- Someone may not qualify for a diagnosis if the experiences they have are considered the norm within their culture.
- Enhanced therapeutic alliance - individual feels seen and heard.
-Tailor treatment planning to client’s identity factors.
Why is it important for clients and therapists to collaborate on goals?
To ensure that the treatment plan is relevant to the client’s needs and relates back to the presenting problem.
To encourage client participation in treatment. The more invested they are, the more likely that they will have a successful treatment outcome.
Regarding motivational
interviewing - In what way is a client’s motivation or readiness to change relevant?
The client’s readiness to change has a significant impact on whether they take action. Therefore, it is important for the therapist to assess what stage of readiness the client is at so that they know how to support them on their journey.
How relevant is the therapeutic alliance to treatment outcome?
Very. Some studies reveal that it is a strong predictor of treatment outcome.
Think back to the “Other Conditions That May Be a Focus of Clinical Attention” in the DSM. Are the conditions in this chapter considered mental health disorders? Why?
No. It includes
conditions and psychosocial or environmental problems that are not considered to be mental
disorders but otherwise affect the diagnosis, course, prognosis, or treatment of an individual’s
mental disorder. Examples: abuse and neglect, housing problems, economic problems, problems related to interaction with the legal system, relational problems, nonsuicidal self injury, etc.
Besides “uncomplicated bereavement” what are 2 other examples of diagnoses in this category (other conditions that may be a focus of clinical attention)?
wandering associated with a mental disorder, phase of life problem, religious or spiritual problem, overweight/obesity, malingering, age-related cognitive decline
For an adjustment disorder diagnosis, how soon after a stressor do symptoms need to begin?
Within 3 months
What
evidence suggests that symptoms are clinically significant for an adjustment disorder?
- Marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the external context and cultural factors that might influence symptom severity and presentation
- Significant impairment in social, occupational, or other important areas of functioning.
How do you distinguish between an adjustment disorder and major depressive disorder?
If an individual has symptoms that meet criteria for a major depressive disorder in response to a stressor, the diagnosis of an adjustment disorder is not applicable. The symptom profile of MDD differentiates it from adjustment disorders
How does Criterion B for Adjustment Disorder differ from a Z code?
Criterion B: tells you whether symptoms are clinically significant.
Z-codes: tells you the mood component (anxiety, depressed, mixed, unspecified, etc.)
The symptoms of adjustment disorder persist within what timeframes?
Onset: within 3 months of stressor
Duration: resolves within 6 months of termination of stressor
For a prolonged grief disorder diagnosis, at least one of what two symptoms characterizing the
development of a persistent grief response must be present? How long must this symptom(s) be
present? How long ago was the death?
1) Intense yearning/longing for the deceased, preoccupation with thoughts or memories of the deceased person
2) Nearly every day for at least 1 month
3) at least 12 months ago
What are some characteristics of individuals who adjust more easily to life stressors?
Strong support system
Positive attitude about life
Meaningful relationships
Overall functioning good prior to event
Stable relationship/finances
Advanced education
Characteristics
of those who are more susceptible to an adjustment disorder?
Family conflict
Poorly controlled physical pain
Substance disorders
Financial difficulties
History of mood/anxiety disorders
Primary focus of treatment for adjustment disorder?
Helping people cope more effectively with changing life circumstances.
A couple of promising therapeutic
approaches for adjustment disorder?
Collaborative, empathetic attitude from therapist
Psychoeducation
Referrals to adjunctive services
Brief and structured interventions
Prognosis for adjustment disorders?
Excellent
What 2 forms can the outbursts in disruptive mood dysregulation disorder (DMDD) take?
Verbally (i.e., verbal rages) and/or physically (i.e., physical aggression toward people/property)
For DMDD, what needs
to be considered about the situation and developmental level?
Criterion B: the temper outbursts are inconsistent with developmental level
Criterion F: Outbursts present in at least 2-3 settings and are severe in at least one of these
For DMDD, how frequently must symptoms occur?
Outbursts occur, on average, 3+ times per week.
For DMDD, what
is the person’s mood like between outbursts?
Mood between temper outbursts is persistently irritable or angry most of the day, nearly every day, and is observable by others
What are common depression symptoms in the DSM-5 criteria of a major depressive episode? How
many symptoms are required and for how long must symptoms be present?
1) Depressed mood
Markedly diminished pleasure in activities
Significant weight loss/gain
Insomnia/hypersomnia
Psychomotor agitation/retardation
Fatigue or loss of energy
Feelings of worthlessness/excessive guilt
Diminished ability to think/concentrate
Suicidal ideation
2) 5; 2 weeks
