OTH: Psychiatric Flashcards
Excessive anxiety not associated with realistically threatening specific situations
Anxiety disorder (anxiety neurosis) - generalized
Acute, intense anxiety or terror; may be uncontrollable, accompanied by sympathetic signs, loss of mental control, sense of impending death
Panic attack
Excessive and unreasonable fear leads to avoidance behaviors
Phobia
Persistent anxiety manifested by repetitive, stereotypic acts; behaviors interfere with social functioning
Obsessive-compulsive behavior
Exposure to traumatic event that produces variety of symptoms
PTSD
PTSD sx:
- ___ the traumatic event
- Psychiatric numbing with __ responsiveness
- __ from external world; __ guilt
- Exaggerated __ arousal, ___alertness
- Disturbed __
- Ongoing __
- Impaired __ and __
- Re-experiencing
- Reduced
- Detachment; survivor’s
- Autonomic, hyperalertness
- Sleep
- Irritability
- Memory, concentration
Physical signs or diseases that are related to emotional causes
Psychosomatic disorders (somatoform disorders)
3 characteristics of psychosomatic disorders
- Cannot be explained by identifiable pathology/process
- Not under voluntary control
- Patient frequently indifferent to symptoms
Pt experiences neurological symptoms (weakness, paralysis, sensory symptoms) without evidence of specific neurological disease or other medical condition
Functional neurological symptom disorder (FNsD)
With functional neurological symptom disorder, pts symptoms are real and cause significant loss of function/emotional distress. Symptoms can vary in __ and __or be __. Cause is __. Tx involves PT or OT for ___ and __ symptoms, and ___ tx.
Severity Fluctuate, be persistent Unknown Functional and movement Psychiatric
Tx for FNsD
- Physical symptoms are real- tx patient as you would any other pt with same presentation
- Provide supportive environment
- ID primary gain (internal conflicts); assist pt to use new alternative methods of stress mgmt
- ID secondary gains (additional advantages)- do not reinforce attention/sympathy
- Provide encouragement/support for total person
Group of disorders characterized by disruptions in thought patterns of unknown etiology; biochemical imbalance in brain
Schizophrenia
Schizophrenia sx:
- Disordered __
- Disordered __
- Disordered __
- ___ of affect
- ___disturbances
- Little __ into problems/behavior
- Thinking
- Speech
- Perception
- Inappropriateness
- Functional
- Insight
Schizophrenia:
What is disordered thinking?
Fragmented thoughts, errors of logic, delusions, poor judgment, memory
Schizophrenia:
What is disordered speech?
May be coherent, but unintelligible, incoherent, or mute
Schizophrenia:
What is disordered perception?
Hallucinations and delusions
Schizophrenia:
What is inappropriateness of affect?
Withdrawal of interest from other people and from outside world; loss of self-identity, self-direction; disordered interpersonal relations
Schizophrenia:
What are functional disturbances?
Inability to function in daily life, work
Type of schizophrenic disorder characterized by feelings of extreme suspiciousness, persecution, grandiosity (feelings of power/great wealth), or jealousy; withdrawal of all emotional contact with others
Paranoia
Type of schizophrenic disorder characterized by mutism or stupor; unresponsiveness; catatonic posturing
Catatonia
What is catatonic posturing?
Remains fixed, unable to move or talk for extended periods
Disorder characterized by mood swings from depression to mania; biochemical dysfunction
Bipolar disorder (manic-depressive illness)
Bipolar disorder: often intense ___, high energy and activity, excessive ___, decreased need for __, unrealistic beliefs, distractibility, poor judgment, denial… followed by extreme ___
Outbursts, euphoria, sleep
Depression
Characteristics of grief process?
Somatic symptoms: fatigue, sighing, hyperventilation, anorexia, insomnia
Psychological symptoms: sorrow, discomfort, regret, guilt, anger
Stages of grief process?
- Shock and disbelief; inability to comprehend loss
- Increased awareness and anguish; crying/anger common
- Mourning
- Resolution of loss
- Idealization of lost person or function
How do you help manage the grief process?
Provide ____ and ___ of grief process. Encourage expression of __, __. Respect ___, cultural or ___ customs.
Support, understanding
Feelings, memory
Privacy, religious
Stages of death/dying: (6)
- Denial
- Anger/resentment
- Bargaining
- Depression
- Acceptance
Death/dying:
Denial- allow denial. Protective compensatory mechanism necessary until such time as pt is ready to face his/her illness. Provide opportunities for what?
Pt to question, confront illness and impending death
Death/dying:
Anger, resentment: patients may become ___ and __ others. Be __, allow pt to express anger, frustration, resentment. Encourage focus on ___ strategies.
Disruptive, blame
Supportive
Coping
Death/dying:
Bargaining- pts bargain for time to complete life tasks; turn to religion or others, make promises in return for function. What can you do?
Provide accurate information, truthful and honest answers
Death/dying:
Depression- pts acknowledge impending death, withdraw from life; demonstrate overwhelming sense of loss and have __ __. Observe closely for ___. Allay fears and anxieties, especially loneliness and ___. Assist in providing comfort.
Low motivation
Suicidal ideas
Isolation
Death/dying:
Acceptance and preparation- acceptance of their condition, relate more to __ make plans for future.
Family
PT interventions
Motivate pts, manage human side of rehab. Establish boundaries of professional relationship: identify problems, ___, ___, roles and ____.
Expectations, purpose, responsibilities
PT interventions
Provide empathetic understanding: capacity o understand what pt is experiencing from __ __
Patient’s perspective
PT interventions
Recognize losses; allow opportunity to mourn “old self.” Ask ____ questions that reflect what pt is feeling
Open-need
PT interventions
___ is not helpful or therapeutic; caregiver is closely affected by pt’s behavior (ex: therapist cries when pt cries)
Sympathy
PT interventions
Set realistic, meaningful goals; how?
Involve the pt and family
Self-determination is important
PT interventions
Set realistic time frames for rehab program; including what?
Recognize symptoms, stages of grief process or death and ying and adjust accordingly
PT interventions
Recognize and reinforce healthy, positive, socially appropriate behaviors: allow pt to do what?
Experience success
PT interventions
Recognize secondary gains, unacceptable behaviors- PT should do what with this?
Do not encourage or reinforce (ex: malingering behaviors such as avoidance of work)
PT interventions
Provide environment conductive to pt’s emotional state, learning, optimal fxn.
1. Provide message of hope tempered with realism
2. Keep pts ___
3. Lay adequate groundwork or preparation for ___
4. Help establish personal __ and __; acknowledge whole person
Informed
Expected changes/discharge
Dignity, self-worth
PT interventions
Help pts identify feelings, successful coping strategies, recognize successful conflict resolution and rehab gains. Stress ability to ___, stress that recovery is unique and ___
Overcome major obstacles
Highly individual
Red flags for depression: (just a few of them)
- Sleep habits?
- Psychomotor imbalance: ?
- Feelings of ?
Insomnia, hypersomnia, decreased energy
Agitation or excess fatigue/irritability
Worthlessness, helplessness, guilt
med tx for depression
Tricyclic antidepressant drugs
Red flags: tricyclic antidepressant drugs-
May exhibit disturbed ___, postural ___, falls and __, increased __, dysrhythmias, ___ mvmt, seizures
Balance Hypotension Fx HR Ataxic
Covering up weakness by stressing desirable or strong trait
Compensation
Refusal to recognize reality
Denial
Refusal or inability to recall undesirable past thoughts/events
Repression
Transferring of emotion to a less dangerous substitute
Displacement
Defensive reaction in which behavior is exactly opposite what is expected
Reaction formation
Attributing of your own undesirable behavior to another
Projection
Justification of behaviors using reasons other than real reason
Rationalization
Resorting to earlier more immature pattern of functioning
Regression
- Total body coping/adaptation to catastrophic event
- Alarm stage fight or flight (sympathetic response)
- Sustained resistance
- Chronic resistance, exhaustion leading to stress-related illnesses
General adaptation syndrome (GAS)
