PMHNP certificate study guide Flashcards
Best Interview Technique for identifying antisocial disorder
The Stress Interview: You confront inconsistencies in the patient history.
Classical Conditioning is learning by
association
Operant conditioning is learning by
consequences
Autonomy
The right to self-govern free from external control or influnece
Beneificence
Doing good, promoting well being
Nonmaleficence
Do no harm
Veracity
Conformity to facts, truthfulness and accuracy
Justice
equitable and reasonable
Respect
regard for the feelings, wishes, rights, and traditions of others
Deontological Theory
An action is judged as good or bad based on its merits REGARDLESS of the consequence
Teleolgical Theory
The goodness or badness of an action is based on its foreseeable consequences
Virtue ethics
Actions are based on moral principles
Dependent Variable
The factor that changes as a result of the independent variable
Independent Variable
The intervention intended to cause the change
Internal Validity
The degree to which an experiment avoids confounding independent variables
The more causative the factors are controlled the higher the
internal validity
A high internal validity indicates
a stronger cause and effect relationship
External Validity
Degree to which findings from one study can be applied to real world situations
The more controls exerted to enhance internal validity the…
weaker the external validity
Reliability
Accuracy over time, items, and researchers
Descriptive Statistics
Identifies basic features of a data set
Inferential statistics
allows samples to be generalizable to the population
Leading cause of death for 1-44
unintentional injuries
Leading cause of death for 45-64
Cancer
Leading cause of death for 65 and older
heart disease
Specificity
Looks for true negatives
Sensitivity
Looks for true positives
Perceived susceptibility
One’s belief regarding the chance of getting a condition
Perceived Severity
One’s belief of how dangerous a condition and its sequelae would be if contracted
Name some of the key concepts of the Health Belief Model
Perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy
Name some key concepts of the Transtheoretical Model (TTM)
Stages of change, Decisional Balance, Self-efficacy, process of change
precontemplation, contemplation, preparation, action, and maintenance are all part of…
The stages of Change from the Transtheoretical Model
Considering pros and cons are part of what part of what health care model?
Decisional Balance from the Transtheoretical Model
Confidence, temptation, importance ruler, confidence ruler are what part of what health care model?
Self-Efficacy from the transtheoretical model
Consciousness raising, dramatic relief, self re-evaluation, environmental re-evaluation, self-liberation, helping relationships, counter conditioning, reinforcement management, stimulus control, social liberation are all part of what part of what health care model?
Process of Change from transtheoretical model
Five parts of Maslow’s hierarchy of needs from base to top
physiologic needs, safety needs, love and belonging, self-esteem, self-actualization
What part of Maslow’s hierarchy does a hospital general provide?
physiological and safety
What part of Maslow’s hierarchy can a partial hospitalization address?
Needs of belonging and eventually self-esteem
What part of Maslow’s hierarchy can vocational rehab, psychodynamic therapy and psychoanaylsis address?
helps work through self-actualization
High risk situations with immediate precipitant to relapse…there are four
Negative emotional states, interpersonal conflict, social pressure, positive emotional states
Leaving a high-risk situation, positive self-talk, calling a friend, planning another activity, contingency planning, avoidance of high-risk situations are all examples of…
effective coping in the relapse prevention theory
Using the vice as the coping strategy, lingering in a high-risk environment, minimizing potential harms are all examples of
ineffective coping in the relapse prevention theory
Belief in one’s ability to effectively cope and the expectation about the outcome
self-efficacy
Cognitive restructuring in which the lapse is distinguished from a relapse and seen as an isolated mistake, the client resumes abstinence behavior despite negative feelings of failure, OR the client decides to negate sobriety and attempts to quell negative emotional state by further lapses.
Abstinence violation effect (AVE)
Learned behaviors occur in a social context, expectations and outcomes reinforce the behavior and increase sustainability
Social Learning Theory
The patient learns a healthy behavior and likes the result, increases likelihood of continuing the behavior
Direct experience
Freebie skip
Freebie skip
The patient observes a negative consequence to a behavior, which reduces the likelihood that the behavior will be adopted. Patient has learned not to do the potentially harmful behavior.
Vicarious learning
Erik Erikson’s developmental stage 0-1
Trust vs. Mistrust
Erik Erikson’s developmental stage 1.5-3
Autonomy vs. Shame
Erik Erikson’s developmental stage 4-6
Initiative vs. Guilt
Erik Erikson’s developmental stage 7-12
Industry vs. inferiority
Erik Erikson’s developmental stage 13-20
identity vs. role confusion
Erik Erikson’s developmental stage 21-35
intimacy vs. isolation
Erik Erikson’s developmental stage 36-65
Generativity vs. stagnation
Erik Erikson’s developmental stage >66
Ego integrity vs. despair
What mental health disorders are associated with mistrust?
Dysthymia, Schizotypal personality, Addictive predisposition
What mental health disorders are associated with shame?
Obsessive compulsive personality disorder, Paranoid personality
What mental health disorders are associated with inferiority?
Dependent personality
What mental health disorders are associated with guilt?
Inhibition Fear, timidity Somatization
What mental health disorders are associated with role confusion?
Antisocial personality, Borderline personality
What mental health disorders are associated with isolation?
Schizoid personality disorder, Avoidant personality
What mental health disorders are associated with stagnation?
Narcissistic, Avoidance
What mental health states are associated with despair?
Isolation and desperation
Building blocks of knowledge. The child develops a mental representation of the world (units of information relating to aspects of the physical world).
Schemas by Jean PIaget
A process that enables the transition from one stage to another
Jean Piaget’s adaptation
Three components of Jean Piaget’s adapatation?
Equilibrium, assimilation, accommodation
A force that moves the development along, happens when a child’s schema can deal with the new information by assimilation
Jean Piaget’s equilibrium
Uses an existing schema to deal with a new object or situation (e.g., an 18-month-old child sees a bald-headed man with a bowtie, and immediately starts crying saying “no doctor, no doctor”).
Jean Piaget’s assimilation
When the child is unable to assimilate the new information into an existing schema, they form a new one (e.g., the 18-month-old child’s mother explains that even though the man is wearing a bowtie and is bald, he is not a doctor because he is not giving the child a shot. The child then learns not every bald-headed man with a bowtie is going to give him an injection).
Jean Piaget, accomodation
What are Jean Piaget’s four stages of cognitive development?
sensorimotor, preoperational, concrete operations, formal operations
What developmental stage is sensorimotor in Jean Piaget’s theory?
Sensorimotor (birth to 2 years): The child learns that an object still exists even if he cannot see it.
What developmental stage is preoperational in Jean Piaget’s theory?
Preoperational (2–7 years): The child learns a symbolic representation of either pictures or words. A child cries if, when he says cookie, he receives a picture of the cookie rather than the cookie. Egocentricity with difficulty taking the viewpoint of another.
What developmental stage is concrete operations in Jean Piaget’s theory?
Concrete operations (7–11 years): Children start to work things out in their heads, develop number conservation (four quarters is the same as $1.00, is the same as 100 pennies).
Sullivan’s Stages of Interpersonal Development Birth-18 months
Developmental task oral gratification
Sullivan’s Stages of Interpersonal Development 18 months to 6 years
Delayed gratification (toilet training)
Sullivan’s Stages of Interpersonal Development 6-9 years
Social skills/peer realtionships
Sullivan’s Stages of Interpersonal Development 9-12 years
Same-sex relationships
Sullivan’s Stages of Interpersonal Development 12-14 years
Opposite Sex relationships
Sullivan’s Stages of Interpersonal Development 14-21 years
Developed self-identity
Freud stages 0-18 months
Oral gratification
Freud Stages 18 months - 3years
Anal/ toilet training/delayed gratification
Freud Stages 3-6 years
Phallic/Sexual exhibitionism
Freud Stages 6-16 years
Latency/socialization and identity development
Defense Mechanisms: Denial
Refusal to believe a painful reality
Defense Mechanisms: Displacement
Shifting an impulse toward a more acceptable object
Defense Mechanisms: Rationalization
Self-Justifying explanation instead of reality which is perceived as threatening
Defense Mechanisms: Projection
Disguising one’s impulse by attributing it to others
Defense Mechanisms: Reaction Formation
Switching unacceptable impulses into the opposite impulse
Defense Mechanisms: Regression
Retreating to a previously mastered developmental stage
Defense Mechanism: Conversion
Psychological angst manifested as a physical symptom
Defense Mechanism: Dissociation
Out of body experience, disconnected from the physical world
Defense Mechanism: Humor
Seeking a funny aspect in a stressful situation to reduce associated anxiety
Defense Mechanism: intellectualization
Considering an emotional issue in intellectual terms
Defense Mechanism: Undoing
Behavior in an attempt to correct a past unacceptable behavior
Defense Mechanism: Sublimation
Substituting a socially acceptable constructive activity for a robust contrasting impulse
Super Ego
Morality, right versus wrong, guilt versus shame, moral obligations versus fantasies. The therapist attempts to function in the role of an external superego.
Clinical caritas guide the practice of nursing and are essential in creating a therapeutic relationship and alliance for healing.
Jean Watson
Cultural care, patients have the same basic needs regardless of culture, but culture provides context for care and meaning for suffering.
Madeline Leininger
Theory of interpersonal relationships. Emphasis on the give and take of the nurse-client relationship, asking open ended questions, reflective listening, affirming, validation, etc..
Hildegard Peplau
A psychodynamic phenomenon characterizing the perceived bond between the patient and therapist. It is the most predictive factor of a successful outcome.
Therapeutic alliance
What are the three phases of therapy?
Orientation, working/treatment, and termination
Based on the premise that unconscious motivations and instinctual drives cause the implementation of defense mechanisms. Change happens by promoting greater insight and awareness regarding defense mechanisms. Based on speculation of psychodynamic development factors that may have occurred earlier in life.
Psychoanalytic therapy
Focuses on present events and maladaptive responses/behaviors. Helps the client to view reality more objectively by examining cognitive distortions and automatic thought patterns.
CBT
Most common and effective therapy for clients with borderline and narcissistic traits. Aims to regulate emotions, increase distress tolerance, develop self-management and interpersonal skills, and promote mindfulness.
DBT
Socratic questioning to enhance reflection and self-confrontation. Based on the premise of finding purpose in one’s life and circumstances. Emphasizes accepting reality and responsible decision-making.
Existential therapy
Sometimes called patient-centered therapy. Assumes man is good. Specific aims include facilitating self-directed growth toward self-actualization and finding meaning in life and circumstances. Gratitude Journals. Encourages socialization behaviors, loving, kindness, meditation, altruism, savoring.
Humanistic Therapy
Socratic questioning to examine interpersonal issues that are creating current distress. Manualized and time limited. Focuses on the present and interpersonal distress. Specially developed for symptoms of depression, effective in adolescents and adults.
Interpersonal therapy
Distraction by bilateral stimulation of both cerebral hemispheres by moving eyes back and forth between two point, or alternating tapping between hands, or stereo sounds alternating between ears. Commonly used in PTSD to achieve adaptive resolution. Patient must be able to tolerate and narrate their trauma.
Eye movement desensitization and reprocessing.
Developed by Irvin Yalom and builds on CBT and psychoanalytic constructs and involves 10 therapeutic curative factors.
Group Therapy
Universality
Participants discover others with similar circumstances, thoughts, feelings, behaviors.
Altruism
Provides an opportunity to help participants progress in something.
Interpersonal learning
Interactions with other people provide opportunities to learn about relationship dynamics and intimacy.
Imitative behaviors
Allows participants to copy the behaviors of others. The behavior may be adaptive or maladaptive.
Group Cohesiveness
Participants develop an attractive to other group members and a sense of belonging is enhanced
Catharsis
The opportunity to openly express previously suppressed feelings, thoughts, and insights
Existential factors
Participants learn to find meaning in loss and suffering, and learn to deal with the frustrations of reality rather than reverting to a previous pattern of avoidance
Corrective Refocusing
Participants can visit issues related to the family of origin through the recapitualtion of family dynamics as they arise within the group. The group serves as a substitute family where group members are siblings and the facilitator is the parental figure.
Installation of Hope
Participants can witness changes in other group members, allowing them to actualize the possibility of social skills.
Increased development of social skills
Group provides a natural laboratory for immediate feedback regarding the effectiveness of an individual’s adaptive or maladaptive behavior
The Five phases of group dynamics
Forming, storming, norming, performing, adjourning
What is the Forming stage?
Feeling guarded and anxious and fearful. The leader should identify goals, expectations, and boundaries in this phase.
What is the Storming stage?
Participants will demonstrate resistance, sabotaging, and clique formation. Leader should allow for expression of both positive and negative feelings and help the group to examine nonproductive behaviors and underlying conflicts.
What is the Norming stage?
Group members overcome initial resistance and begin to develop cohesion. Open and spontaneous communication occurs and the group norms are solidified.
What is the performing stage?
The primary objective and work of the group become more focused, members begin to engage in creative problem-solving, interpersonal learning takes place in the group, and the group is unified toward goal achievement.
What is the Adjourning stage?
Active termination process. Leaders and members express feelings about each other in regard to termination, review achieved goals and outcomes, and identify future work remaining.
Protective mechanisms that maintain the functional integrity of the family unit, individuals, and subsystems within the family.
Boundaries
This type of boundary causes estrangement in the long-term or disengagement in the short term.
Rigid Boundaries
This type of boundary causes enmeshment and parentification of children.
Diffuse boundaries
This type of boundary allows individuals to maintain their unique identities while communicating love and belonging to all members of the system.
Clearly defined boundaries.
circular causality
a feedback loop characterized by a series of actions and reaction that pereptuate a problem.
Familial tendency to resist change in order to maintain a steady state, even if the state is one of dysfunction.
Homeostasis
The family’s tendency adn ability to change when necessary or remain the same in the midst of change.
Adaptability
This assumes an individual’s behavior serves a role or function with in the family unit perpetuating or protecting against dysfunction.
Family systems therapy
Perceiving one’s intrinsic value rather than depending on external relationships and circumstances to derive self-worth.
Self-differentation
A dyadic relationship that extends to a triad in order to reduce stress within the dyad more commonly occurs in morphostatic (less adaptable) families
Triangles
Characterized in families where parental units, levels of differentiation are reflective of familial differentiation (e.g. if parents perceive their intrinsic self-worth, those in their care will also perceive their self-worth).
Nuclear Family
Passing along dysfunctional behaviors throughout generations of the family unit.
Transmission process
Parental differentiation is transmitted to the most susceptible child. (Parent derives their self-worth from the relationship with a child, creates an enmeshed dyad).
Projection Process
The breaking of contact with the family of origin
Cutoffs
An influencing factor in familial interactions and individual personality characteristics.
Birth order
Drawing from a family systems therapy in which the therapist’s role is to gain an understanding of familial transactions in order to implement a change of organization to manage problems more effectively. Symptoms are a product of dysfunctional transaction patterns within the family. The family structure is a frame created by functional demands that articulate the transactional processes.
Structural family therapy
