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Conditions + definitions > Psych 2 > Flashcards

Psych 2 Flashcards

1
Q

What is stigma?

A

A social construction that devalues people to a distinguishing characteristic or mark

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2
Q

What are the methods to reduce stigma?

A

Good manage managment
Consider own attitudes
Personal experience
>The more exposure the less likely to stigmatise that thing

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3
Q

What is psychosis?

A

A severe form of psychosis
Often with a lack of insight
Inability to distinguish between symptoms of delusion, hallucination and disordered thinking from reality

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4
Q

What are Hallucinations?

A

Have the full force and clarity of true perception
Located in external space
No external stimulus
Not willed or controlled

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5
Q

What is a delusional belief?

A

Unshakeable idea or belief which is out of keeping
>Which is out of keeping with the person’s social and cultural background
Held with extraordinary conviction

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6
Q

How commin is schizophrenia and who gets it?

A

1%
Males and females equally
Age of onset 15-35 years

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7
Q

What are the symptoms of schizophrenia?

A

+ve
Hallucinations
Delusions (paranoia, somatic, reference)
Disordered thinking/speech

-ve
Apathy
Lack of interest
Lack of emotions

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8
Q

How do you diagnose schizophrenia?

A

1 month history in absence of organic affective disorder
+1 main criteria
+2 other criteria?

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9
Q

What are the main criteria for schizophrenia?

A

Alienation of thought
Delusions of control, influence or passivity
Hallucinatory voices
Persistent delusions of other kind that are outwith cultural norms + impossible

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10
Q

What are the secondary criteria for schizophrenia?

A

Peristent hallucinations
Neologisms, breaks or interruptions in train of thought
Catatonic behaviour
Negative symptoms

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11
Q

What biological factors are implicated in causing schizophrenia?

A 
Obstetric complications
Maternal influenza
Malnutrition and famine
Winter birth
Substance misuse
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12
Q

What is What are the biological factors of schizophrenia?

A

Familial genetics link, stronger in twins
Certain syndromes
GABA/glutamate

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13
Q

What are the social/psychological factors of schizophrenia?

A

Occupation and social class
Migration
Social isolation
Life events as preciptants

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14
Q

What are the differentials for schizophrenia?

A

Delerium
Depressive episode with psychotic symptoms
Manic episode with psychotic symptoms

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15
Q

What are the symptoms of delerium?

A

Prominent visual experience, hallucinations and illusions
Affect of terror
Delusions are persecutory and evanescent
Fluctuating, worse at night

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16
Q

How do you treat resistant schizophrenia?

A

Clozapine

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17
Q

What are the good prognostic factors for schizophrenia?

A 
No family history
Good premorbid function
Clear precipitant
acute onset
Mood disturbance
Prompt treatment
Maintenance of initiative and motivation
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18
Q

What are the poor prognostic factors for schizophrenia?

A

Slow, insidious onset
Prominent negative symptoms
Starting in childhood

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19
Q

How does the mental hjealth act define a mental disorder?

A

Any mental illness
Personality disorder
Or learning disability
However caused or manifested

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20
Q

What are the civil compulsory power, how long do they last?

A 
Emergency detention - 72 hours
Short term detention - 28 days
Compulsory treatment order - up to 6 months
Nurses holding power
>Detention up to 3 hours
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21
Q

What are the criteria for detention certificates?

A 
Must have mental health disorder
Decision making impaired/lacks capcity
Risks to health
Treatment is available/necessary for treatment
Least restrictive option
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22
Q

Who is able to authorise the civil detention certificates?

A

Emergency - Any registered medical practitioner
Short-term - any approved medical practitioner (APM)
Compulsory - APM + GP or APM unkown to department
>Taken before tribunal and mental health officer

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23
Q

Who is an adult in:

1) adults with incapacity?
2) mental health act?

A

Incapcity = 16

Mental health act - 18

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24
Q

What determines incapabable in the incapacity act?

A 
Incapable of:
Acting
Making decisions
Communicating decisions
Understanding decisions
Retaining memory of decisions

(However, if human/mechanical aid can help with this, they are not then incapable ie sign language with deaf person)

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25
Q

What are the crieria for the incapacity act?

A

Intervention must benefit adult
Least restrictive
Must take into account past/present wishes of adult
When practicable, relatives/carers account taken

NO mental health disorder
For/detention not to be used unless necessary
Action must be consistient with what a competent court would decide

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26
Q

What are the powers of the court?

A

Intervention order - one time

Guardianship order - full time person appointment to make decisions on behalf of individual

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27
Q

What are the criteria of police powers for mental disorders?

A

Removal from public space
Appears to be in immediate need of care/treatment to place of safety
Detain for up to 24 hours
To allow for assessment and make arrangements for care and treatment

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28
Q

What determines criminal responsibility with mental health?

A

> Person is not criminally responsible for offence if at the time was due to mental health disorder was unable to distinguish wrongfullness of situation
Not if disorder is a personality disorder which is characterised by abnormallyy aggressive or irresponsible conduct

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29
Q

What can cause unfitness for trial?

A

Incapable of mental or physical condition of participating effectively in a trial
Ability to:
>Understand nature of charge
>Requirement to tender a plea to charge and effect of such plea
>Understand evidence
>Understand purpose + follow the trial
>Instruct/communicate with legal defence

Unable to remember doesn’t count

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30
Q

What setermines diminished responsibility?

A

Murder becomes culpable homicide if person’s ability to determine/control conduct at the time was impaired by abnormality of mind
>A mental disorder
?Alcohol/drugs are not in themselves enough

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31
Q

What are the forensic sections?

A 
Compulsion order
Restriction order
Assessment order
Treatment order
Interim compulsion order
Transfer for treatment direction
Hopital direction
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32
Q

What are the criteria for a forensic section?

A

Mental disorder
Detention is needed
Treatment avialable
Risks to self/others

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33
Q

In regards to an assesment order:
How long does it last?
When is it used?

A

Lasts 28 days
When court think you are ill
>Whilst waiting for trial

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34
Q

In regards to a treatment order:
How long does it last?
When is it used?
Who authorises it?

A

Lasts until you are acquited or convicted
Waiting for trial and court thinks you are ill
Need two doctors, one being a psychiatrist and you to agree

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35
Q

In regards to a temporary compulsion order:
How long does it last?
When is it used?
Who authorises it?

A

Mo fixed time
Used when too ill to continue with trial because of mental illness
Two doctors have examined and agree

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36
Q

In regards to an interim compulsion order:
How long does it last?
When is it used?
Who authorises it?

A

Convicted of offence + prison
12 weeks
Needs 2 doctors, they must state you need to go to hospital

37
Q

In regards to a compulsion order:
How long does it last?
When is it used?
Who authorises it?

A 
Convicted of offence and sentence prison
>Sent instead to treatment in hospital
>Must have mental disorder + treatable + risk + necessary
Lasts up to 6 months
2 doctors, with 1 being a psychiatrist
38
Q

In regards to a restriction order:
How long does it last?
When is it used?
Who authorises it?

A

If person serious risk to public
>On top of compulsion order
No time limit
Scottish minster musct give approval
>For any periods out of hospital, or moving between hospitals
Reviewed every 2 years or on psych evidence

39
Q

What is a personality disorder?

A 
Enduring patter of following areas:
>Cognition
>Affectivity
>Interpersonal feeling
>Impulse control
Pattern inflexible and pervasive
Clinically significant distress or impairment in a range of areas needed for functioning
Pattern is stable and traced back to early adulthood
Not explained by a different diagnosis
Not attributable to phsiological change
40
Q

What are the cluster A personality disorders?

A

Characterised by profound concern about basic safety of any human relationship:
Schizoid
Schizotypal
Paranoid

41
Q

What is paranoid personality disorder?

A 
No-one expected to have anything but malign intent
No hallucinations/delusions
Suspects exploitation/harm from others
Hidden meanings
Bears grudges
Recurrent suspicion 
Not due to anything else
42
Q

What is schizoid personality disorder?

A

Pervasive pattern of detatchment from social relationships
Restricted range of expression of emtion in interpersonal settings
Doesn’t want to have close relationships/family
Solitary activites
Lacks close friends/confidants
Indifferenant to praise/critism of others

43
Q

What are the cluster B personality disorders?

A 
Inability to hold certain feelings without acting upon them
Narcissistic personality disorder
Borderline personality disorder
Antisocial personality disorder
Histronic personality disorder
44
Q

What is antisocial/dissocial personality disorder?

A 
Repeated disregard + violate rights of others
Failure to conform to social norms with respect to lawful behaviours
Deceitfulness
Impulsibity
Irritability + aggressiveness
Reckless disregard for self/others
Consistient irresponsibility
Lack of remorse
45
Q

What is borderline personality disorder? AKA emotionally unstable personality disorder

A

Uncertain sense of safety of relationships
>Prone to feeling abandoned
Try to manage by hurtin/killing self

Frantic effort to avoid abandonment
Persistiently unstable self-image /sense of self
Recurrent suicidial behaviour
Chronic feelings of emptiness
Inappropriate anger/controlling anger difficulties

46
Q

What is narcissistic personality disorder?

A

Pervasive pattern of grandiosity
Lack of empathy
Precoccupied with fantasies of unlimited success, power, brilliance etc
Believes speical/unique
Interpersonally exploitative (takes advantage of others)
Envious of others
Arrogant

47
Q

What is histrionic personality disorder?

A

Pervasive pattern of excessive emotionality + attention seeking
Uncomfortable when not centre of attention
Interaction with others inapproriately sexually seductive/provaocative
Rapidly shifting shallow emotions
Consientious use of apperance to draw attention to self
Style of speech excessively impressionistic
Self dramatisation
Suggestible
Consideres relationships more intimate then actually are

48
Q

What are the cluster C personality disorders?

A

Prominent problems relating to anxiety + how it is managed
Dependent personality disorder
Obsessive compulsive personality
Avoidant personality disorder

49
Q

What is dependent personality disorder?

A

pervasive + excessive need to be taken care of leading to submissive/clinging behviour
Difficulty making everday decisions without advice
Needs others to assume responsibility for most major areas of life
Has difficulty expressive disagreement with others for fear of loss of support
Difficulty initiating projects /doing things by self
Excessive lengths to obtain nurturance + support from others
Uncomfortable/helpless when alone
Uregently seeks another relationship for support/care after previous has ended

50
Q

What is obsessive compulsive disorder?

A

Pervasive pattern of preoccupation with orderliness, perfectionism and mental/interpersonal control
>At expense of flexibility, openness and efficiency
Preoccupied with details/lists/rules etc to major point of activity is lost
Perfectionism that interferes with task completion
Excessively devoted to work/productivity
Overconscientious + inflexible about morals/ethics
Reluctant to delegate unless done to their standard
Misery spending style to be hoarded towards future
Rigidity or stubbornness

51
Q

What is Avoidant personality disorder?

A

Pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation
Avoids occupational activities that involve significant interpersonal contact due to fears or criticism
Unwilling to get involved unless certain of being liked
Restraint in intimate relationships for fear of shame/ridicule
Preoccupied with being rejected in social situations
Views self as socially inept/unappealing/inferior
Reluctant to take personal risks because may be embarrassing

52
Q

What is tolerance?

A

Reduced responsiveness to drug caused by revious administration

53
Q

What are the mechanisms of tolerance?

A

Dispositional - less reaches active site
- decreased absorption, metabolism
Increased rate of metabolism to inactive metabolites
Increased excretion

Pharmacodynamic - site less affected by drug
>Down-regulation
>Reduced signalling etc

54
Q

What is the withdrawl phenomena?

A

The withdrawl effect of a drug is the reverse of the acute affect of the drug
Eg - opiates cause constipation, when withdrawn can cause diarrhoea

55
Q

What is cocaine?

A

Natural stimulant (from coca plant)
>Coca leaves can be chewed/brewed
>Cocain hydrochloride snorted/injected
Smoking/injecting gives fastest response

56
Q

What are the effects of cocaine?

A

Stimulant and euphorant
Increased alertness and energy
Increased confidence + impaired judgement
Lessens appetite + desire for sleep

57
Q

What are the side effects of cocaine?

A 
Damage to nose and airways
Convulsions with respiratory failure
Cardiac arrhytmias/MI
Hypertension
Toxic confusion
Paranoid psychosis
58
Q

What are the withdrawl effects of cocaine?

A 
Depression
Irritability
Agitation
Craving
Hyperphagia
Hypersomnia
59
Q

What is amphetamine?

A

“speed”
Stimulant, like cocaine but longer lasting
Sniffed, swallowed or injected
Amphetamine sulphate

60
Q

What are the optiates?

A 
Opium
Morphine
Heroin
Methadone
Coedine/dihydrocodeine
61
Q

What is heroin?

A

Opiate
Taken by smoking, snorting and injection
Injection most dangerous, smoking least

62
Q

What are the side effects of heroin?

A 
Analgesia
Drowsiness/sleep
Mood change
Respiratory depression
Cough reflex depression
Sensitisation of labryinth
Decreased sympathetic outflow
Lowering of body temp
Pupillary constriction
Consitpation
63
Q

What are the side effects of opiates?

A

Nausea/vomiting + headache first time
Phlebitis
Anorexia
Constipation

Long term
Tolerance
Withdrawl
Social/health problems

64
Q

What is opiate withdrawl syndrome?

A 
Craving
Insomnia
Yawning
Muscle pain/cramps
Increased salivary, nasal + lacrimal secretions
Dilated pupils
Piloerection
65
Q

What are the benfits of methadone maintenance?

A

Decriminalises drug use
Allows for normalisation of lifestyle
Reduces IV misues
>However, leakage onto ilicit market

66
Q

What is ecstasy?

A

MDMA
Tablet form
Causes relaxed euphoric state without hallucinations

67
Q

What are the effects of ecstasy?

A

Euphoria followed by harm
Increased sociability
Inability to distinguish between desirable and not
20 mins to 2-4 hours

68
Q

What are the side effects of ectasy?

A 
Nausea and dry mouth
increased blood pressure and temperature
in clubs users risk dehydration
large doses can cause anxiety and panic 
drug induced psychosis
? liver and brain cell damage
69
Q

What is cannabis?

A

Tetrahydrocannabinol psychoactive agent
Usually smoked, sometimes eaten
Relaxing/stimulating euphoriant

70
Q

What are the effects of cannabis?

A

Increased sociability + hilarity
Increased appetite
Changes in time perception
Synaesthesia

In higher doses causes:
Anxiety
Panic
Persecutory ideation
Hallucinatory activity
71
Q

What are the side effects of canabis?

A

Respiraoty problems, like tabacco
Toxic confusion
Exacerbation of major mental illness
Psychosis - linked

72
Q

What are anabolic steroids?

A 
Family of drugs consisting of testosterone and synthetic analogues
Legitimately prescribed in hypogonadism
Muscular dystophy
Some anaemias
And wasting in AIDs

Muscle hypertrophy particularly marked in upper body - pecs, deltoids, trapezius + biceps

73
Q

What are the side effects of steroids?

A 
Acne, strech marks, baldness
Feminisation in males with hypogonadism/ gynaecomastia
Virilisation in women
Growth deficits because of premature closure of epiphyses
Liver disease (jaundice + tumours)
Increased cholesterol + hypertension
Anger
Hypomania + mania
Depression/suicidality on withdrawl
74
Q

What mental health leads to poor school attendance?

A 
Learning difficulties
CO-morbid specific learning problems
Difficulty controlling emotion 
Anxiety
Lack of energy/motivation
Difficulties joining in
Sensory problems - too noisy
Preoccupations - eg germs
75
Q

What is autism?

A

Syndrome with distinctive behavioural abnormalities
Associated with low IQ
Pervasive and present across lifespan + settings
Heritable
Male more than female

76
Q

What is theory of mind?

A

The ability to be able to imagine what others might be thinking based on their knowledge and not your own.
Eg - A person will look for an object where they last remember it being, even if you know as a spectator that it is not there.

77
Q

What is truancy?

A

The act of staying away from school with good reason

78
Q

What is the out of school matrix?

A

Compares the motivation for not going to school

Eg - is it because they are afraid of school, unwilling or have a good reason?

79
Q

What are the changes in the amygdala in anxiety disorders?

A

Activity suppressed by right ventrolateral amygdala when labeling emotions
Reduced connectivity between right ventrolateral cortex and amygdala in GAD in adolescents

80
Q

How do you treat kids avoiding school because of anxiety?

A

Behavioural:
Desensitise
Help overcome fear
Manage feelings

SSRIs

81
Q

How should you manage CBT with children and their families?

A 
Don't expect children to have cognitive awareness
Parents should be collaborators
Step-wise processes
Externalisation - do not blame them
Problem solving to overcome barriers
82
Q

What are the clinical features of autism spectrum disorder?

A 
Decreased sharing
Decreased social understanding
Decreased percepctive of others
Increased technical understanding
Increased rigidity/fixed learning patterns
83
Q

What are teh clinical complications/problems that can arise from someone being autistic?

A 
Learning disabilities
Disturbed sleep
Hyperactivity
High levels of anxiety/depression
OCD
School avoidance
Aggression
Self-injury
Suicidal behaviour
84
Q

What are the causes of autism?

A

Strongly genetic

Congenital causes as well (downs, rubela)

85
Q

How do you manage autism?

A 
Acknowledge
Establish needs
Appreciating can't vs won't
Decrease demands -> reduce stress -> improve coping
Psychopharmacology
86
Q

What are the key features of oppositional defiance?

A 
Refusal to obey with adults request
Often argues
Often loses temper
Deliberately annoys people
Touchy or easily annoyed by others
Spiteful/vindictive
87
Q

How does Opositional defiance differ from ADHD?

A

ODD behaviour is learned, and enacted to obtain a result
ODD likely to be from impaired functioning and adversity

Whereas ADHD is impulsive and poor cognitive control/ability to sustain a goal
ADHD stronger genetic component

88
Q

What is parent training?

A

Groups/indivual/self taught
A strucutred program informed by social learning theory
Focuses on positive reinforcement ofdesired behaviour and developing positive parent-child relationships

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