Payne Midterm Flashcards
Inability to initiate and persist in activities, showing little abilities to perform daily functions (personal hygiene) , also refered to as Apathy
Avolition
Absence of speech, a person responds to questions with brief responses, little content, and appear uninterested in conversation.
Alogia
Also known as poverty of content
Alogia
Delayed comments/ slow responses to questions
Alogia
lack of pleasure experienced by some people (prevalent in mood disorders), indifference to activities that would be typically pleasurable (eating, social interactions, sexual relations)
Anhedonia
Flat affect
Affective Flattening
1/4 of people with Schizophrenia exhibit flat affect. Similar to people wearing masks because of lack of emotions
Affective Flattening
What are examples of negative symptoms?
- avolition
- alogia
- anhedonia
- affective flattening
List of Disorders with disorganized speech
- loose associations (derailment)
- tangential
- circumstantial
- confabulations
- word salad
- rumination
- thought blocking
- clouding of consciousness
AKA derailment
loose associations
Vague, diffuse, and unfocused thoughts that drift aimlessly
loose associations
getting off the topic of the moment toward an irrelevant/ unrelated topic
tangential
over meticulous, too many associated ideas come to consciousness, ordinary topics communicated in an absurd/bizarre degree
circumstantial
replacing memory loss by fantasy or reality that’s not true for the occasion. gaps in memory are filled in, to which client believes answers to be true
confabulations
Saying a mix of phrases that are meaningless to the listener, using coded language
word salad
persistence of thought; preoccupation with a certain idea that can’t be gotten out of client’s head
rumination
sudden end of thought in the middle of a sentence. instead of continuing with thought, new ideas come up, in which the client and observer can’t bring to connection with the previous thought
thought blocking
drowsiness, slow to react, muddled in thinking, reduced clarity of awareness ( as in delirium)
clouding of consciousness
persons with Schizophrenia often experience numerous episodes of the disorder over time. The PRODROMAL phase of an episode refers to
the early signs/symptoms of an episode
What would be needed to assess from a culturally competent perspective?
- role of the client’s religious beliefs/spirituality
- client’s ethnicity
- vulnerability to certain MH disorders among certain ethnic/racial groups
- help-seeking behavior
Mandy is a client who has presented with HALLUCINATIONS &; DELUSIONAL thinking for at least 6 months, but she has NOT exhibited mood disorder issues. What disorder is Mandy MOST LIKELY experiencing?
Schizophrenia
What behavior would be considered a negative symptom of schizophrenia?
inattentiveness
These medications are primarily used to treat psychotic disorders
- Zyprexa
- Risperdal
- Geodone
- Clozaril
Which psychotic disorder means poverty of content or absence of speech?
alogia
1 - 6 Months, No Mania, 2 of 5 sx (1+)
Schizophreniform Disorder
6 months or longer, no mania, 2 out of 5 sx (1+)
Schizophrenia
1 month, delusions ONLY, no mania
Delusional Disorder
1 Day - 1 Month, No Mania, 1 of 4 sx
Brief Psychotic Disorder
2 weeks w/o mood sx, other weeks with mood sx, mania or major depressive episode, 2 out of 5 sx (1+)
SchizoAffective Disorder
One Major Depressive Episode, No Mania
Major Depressive Disorder, Single Episode
building blocks towards dx, comes out in waves
episodes
3 major episodes
- major depressive episode
- manic
- hypomanic
More than 1 major depressive episode, no mania
Major Depressive Disorder, Recurrent
if someone has at least 1 manic episode (doesn’t matter how many), What is the dx?
Bipolar 1
1 major depressive episode + at least 1 hypomanic episode =
Bipolar 2
2 yrs of mild depressive sx, no mania, 2 of 6 sx
Persistant Depressive Disorder AKA Dysthymic
low grade depression over a long period of time
Dysthymic
2 weeks, 5 out of 9, no mania
Major Depressive Disorder
2 years of Mild Depressive sx (not MDE), 2 years of Hypomanic episodes (not manic)
Cyclothymic Disorder
1 week, 3 out of 4 sx, mood disturbance is SEVERE causing impairment in functioning (unless hospitalized, less than 7 days)
Manic episode
4 days, no severe enough to cause impairment
hypomania
2 years, mild highs/mild lows, doesn’t meet criteria for Bipolar 2
Cyclothymic
A practitioner’s ability to demonstrate certain skills based on his or her knowledge and experience.
- Being able to actually demonstrate and apply skills, not just the potential
- Being in the middle (not much self doubt, but not overly confident)
- Comfortability, but seeking continuous learning
Clinical Competence
Anything that falls under the DSM-5 PRIMARY category for diagnosis must:
Absolutely meet diagnosis criteria, has to be the most pressing and affecting multiple areas of life
Anything that falls under the DSM-5 SECONDARY category for diagnosis must:
Absolutely meet diagnosis criteria
dopamine is correlated to
MANIA
mania is related to which drug?
LITHIUM
what is the most important for each person?
salience
What can fall under the DSM-5 PRIMARY category for diagnosis?
Must absolutely meet diagnosis criteria, what is most pressing and affecting multiple areas of life
What can fall under the DSM-5 SECONDARY category for diagnosis?
Has to absolutely meet diagnosis criteria
Secreted in response to stress, influences affective behavior, located in limbic system, influences alertness, regulates anxiety and tension (some meds will target this, ie: anxiety meds)
Norepinephrine
plays a role in pleasure center of the brain, influences emotional behavior and cognition, abnormalities are implicated in schizophrenia and Parkinson’s, helps regulate endocrine system
Dopamine
Amino acid, present through CNS, certain anti-anxiety meds enhance its effectiveness, receptor A deals with anxiety, almost all cerebral functions are influenced by it
GABA (Gamma- aminobutyric)
Anything that falls under the DSM-5 PROVISIONAL category for diagnosis must:
Be a R/O (Rule Out) and in need of more evidence/information
Systems of knowledge, concepts, rules, and practices that are learned and transmitted across generations
Culture
A culturally constructed category of identity that divides humanity into groups based upon a variety of superficial physical traits attributed to some hypothetical intrinsic biological characteristics.
- Conceptualize, social construction, conceptualized based upon physical characteristics
Race
block the reuptake of serotonin
SSRI’s
treatment for Depressive Disorder
- CBT
- IPT
- psychoeducation
- social skills training
treatment for Bipolar Disorder
- CBT
- IPT
- DBT (Dialectic Behavioral Therapy)
- Medication Management/ Case Management
A culturally constructed group identity used to define people and communities
Ethnicity
Understanding of culture and its function in human behavior and society, recognizing the strengths that exist in all cultures.
- Obtain education to seek understanding
- Understanding that you don’t know everything, keeping an open mind
- Having a little information of multiple cultures
- Culturally sensitive
Cultural Competence
______ is:
- Wanting to try and get here
- Understanding that you don’t know everything
- Approaching with curiosity (open mind to learn)
- Open to learning all the time
- Recognize and challenge power imbalances
Cultural Humility
What is the difference between Cultural Competence and Cultural Humility?
Cultural Humility is higher than Cultural Competency.
Cultural Humility is a greater achievement than Cultural Competency.
What is the difference between 1st gen & 2nd gen antipsychotic meds?
1st gen: conventional, blocks dopamine throughout the body, reduces + sx, causes extrapyramidal symptoms like tardive dyskinesia (dangerous side effects (Thorazine, Haldol, Prolixin)
2nd gen: atypical, selectively blocks dopamine, reduces + and - sx, fewer side effects but costs more (Abilify, Clozaril, Risperdal, Geodon)
Differences in access to care or quality of care for people
Healthcare Disparity
Differences in access to care or quality of care, for certain racial groups or socioeconomic groups (some less likely than others).
-Under utilization of Mental Health services in certain racial and ethnic groups
Mental Health Disparity
hypothesis that states low levels of serotonin in the body causes neurotransmitters to swing, which contributes to mood irregularity, including depression
Permissive Hypothesis
works better than other drugs, if one eats anything fermented (cheese, wine) they could die
MAO
Increases production of transmitter (release of neurotransmitter)
Aganistic Agent
mania has too much of what
Dopamine
The following are all causes of _____:
- Biological Factors: Genetic, Hereditary, Neuro, Brain Damage
- Environmental: Trauma, Self-Neglect,
- Chemical Imbalances: Substance Abuse/Use
Causes of Mental Illness
legal concept, clinicians reliably predict client’s actions about events such as suicide (written in the progress notes)
forseeability
Seeking help without saying it, punishing someone, attention. Take this seriously because they can still kill themselves. Just as fatal ( Example of bf/gf trying to kill themselves to get the attention of a person.)
instrumental suicide related behavior
verbal/nonverbal act that stops short of directly doing something
suicide threat
behaviors showcases which intent?
implicit intent
what the client says (verbal) showcases which intent?
explicit intent
Increases production of transmitter (release of neurotransmitter)
Aganistic Agent
Too much dopamine leads to Parkinson’s disease, slows down production of
Antagonist
If MDE (Major Depressive Episode) is still present after 2 months of loss
complicated bereavement
Schizophrenia Patient Outcomes Research Team
PORT
- medication
- family intervention
- ACT
- Token economy are examples of which type of treatment?
PORT
Midbrain and hypothalamus areas, sensory processes, affects muscle activity and thinking, works to calm the nervous system, contributes to affective disorders
Serotonin
Stimulates nerve cell activity, used in the production of GABA, major influence on cognitive functions via the cortex and hippocampus, may overstimulate many neurons (excitotoxicity) to the point of damaging or destroying them
Glutamate
1st generation of antipsychotic medication
- Thorazine
- Prolixin
- Haldol
- Loxitane
- Mellaril
- Navane
2nd generation of anitpsychotic medication
- Abilify
- Clozaril
- Zyprexa
- Seroquel
- Risperdal
- Geodon
All neurons, muscles and heartbeat, affects arousal attention and memory, affects motivation and movement, linked to overall cognitive function (not something you see used in psychotropic meds)
Acetylcholine
Selective Serotonin Reuptake Inhibitiors
SSRI’s
examples of SSRI’s
- Zoloft
- Prozac
examples of tricyclic antidepressants
- Adapin
- Elavil
examples of MAO inhibitors
- Marplan
- Nardil
IPT stands for
Interpersonal Psychotherpay
Similarities with CBT and IPT is
-time-limited therapy
psychodynamic therapy has ___ time
unlimited
Males are 4-5 times more likely to commit suicide than females
True
Females are 3 times more likely to attempt
suicide than men.
True
Federal Government Group Designations:
The Federal government officially designates 4 major racial or ethnic minority groups in the United States, What are they?
- African American/Black
- Asian/Pacific Islander
- Hispanic American/ Latino, and
- Native American/American Indian/ Alaskan Native
medication is the first line of defense for treatment
true
Helps flight or fight response, released during situations of stress or excitement, regulate attention and cognition, also known as Adrenaline
Epinephrine
how a client is presenting their mood
affect
what does oriented x4 mean?
- time
- place
- person
- self
________ Clients are:
- Underrepresented in mental health treatment
- Often seek guidance from religious figures when faced with personal difficulties
- High rates of marriage, low rates of divorce.
- Greater tendency to live in extended family households
- Patriarchal family structure/ machismo
- Mistrust due to fear of deportation for some individuals, or mistrust due to experiences of imprisonment or government murder in El Salvador and Argentina, etc.
- Lack of language proficiency at mental health centers may increase attrition rates.
- Some studies have found that Latinos have higher rates of depression than whites and other groups.
- Lower income immigrant Latinos have been found to be at lower risk for psychiatric disorders than those who are more acculturated
Latino Clients
______ Clients are:
- Underrepresented in mental health treatment
- Show a tendency not to dwell on morbid or upsetting thoughts
- Dislike behaving in a fashion to disrupt social harmony
- Somatization (expressing mental distress in terms of physical suffering)
- High rates of marriage, low rates of divorce.
- Greater tendency to live in extended family households
- Belief in honoring elders
- “Model minority syndrome” – high rates of economic/ academic success
- Loss of face, extreme shame in coming to mental health centers
- Limited English proficiency among some Asian immigrants may keep them from care
- Previous refugee experiences of groups like Vietnamese, Indochinese, and Cambodian immigrants may cause them to mistrust care
- Slow metabolizers of several antipsychotic medications and antidepressants
Asian Clients
_____ Clients are:
- Belief in honoring elders
- Spirituality a key part of culture
- History of depression, PTSD, and alcoholism being significant problems
- Suicide occurs at higher levels than other racial/ ethnic groups
- American Indians’ past experience in this country also imparted lack of trust in government.
- Through the IHS (Indian Health Service), there is a specialized system of care available for Native Americans that provides mental health treatment.
- Also, governmental laws are different for Native Americans who live on tribal lands than other groups. For those individuals, the tribe government takes precedence over the American government, such that they deal with mental health, child protection, and other issues through the tribal government rather than through American mental health systems.
Native American Clients
____ Clients are:
- Often experience high levels of anti-LGBT stereotypes in their everyday lives
- Have to deal with issues of isolation from family, lack of social support at times, and/or being disowned by family members
- Transgender people often have to educate their own counselors
- Often experience harassment, belittlement, and or bullying
- Sometime experience hostility or indifference from their peers
- May experience self-protectiveness or anxiety about encountering homophobia
- Some behaviors, such as some gay men acting like a queen, can be pathologized as being histrionic or borderline personality disorder.
LGBT Clients
false belief based on incorrect inference about external reality that is firmly held, despite obvious proof/evidence it’s not true
delusion
perception-like experience with clarity and impact of true perception
hallucination
Schizophrenia is costly
true
This subtype applies when the central theme of the delusion is that another person is in love with the individual.
Delusional Disorder, Erotomanic type
This subtype applies when the central theme of the delusion is the conviction of having some great (but unrecognized) talent or insight or having made some important discovery.
Delusional Disorder, Grandiose type
This subtype applies when the central theme of the individual’s delusion is that his or her spouse or lover is unfaithful.
Delusional Disorder, Jealous type
This subtype applies when the central theme of the delusion involves the individual’s belief that he or she is being conspired against, cheated, spied on, followed, poisoned or drugged, maliciously maligned, harassed, or obstructed in the pursuit of long-term goals.
Delusional Disorder, Persecutory type
This subtype applies when the central theme of the delusion involves bodily functions or sensations.
Delusional Disorder, Somatic type
Definition = there is too much dopamine in schizophrenics
Dopamine Theory
What are the main categories of the MSE (Mental Status Exam)?
- General Appearance
- Psychomotor Behavior
- Mood and Affect
- Speech
- Cognition
- Thought Patterns
- Level of Consciousness
Name the Criteria for Severity for current (or most recent) episode from the definition below:
Few, if any, symptoms in excess of those required to make the diagnosis and symptoms result in only minor impairment in occupational functioning or in usual social activities or relationships with others.
Mild
Name the Criteria for Severity for current (or most recent) episode from the definition below:
Symptoms or functional impairment between “mild” and “severe.“
Moderate
Name the Criteria for Severity for current (or most recent) episode from the definition below:
Several symptoms in excess of those required to make the diagnosis, and symptoms markedly interfere with occupational functioning or with usual social activities or relationships with others. Psychotic features may be present (Delusions or Hallucinations).
Severe With or Without Psychotic Features
