Psych Exam #1 Flashcards
Dorthea Dix
Reformed mental health treatment; opened 32 state hospitals that offered asylum; advocated for shelter, nutritious food, and warm clothes
Insane Asylums
1790s; safe haven or refuge offering protections from institutions where people had been whipped, burned, beaten, and starved due to mental illness
Who created insane asylums?
Philippe Pinel and William Turke
First 2 drugs to be developed?
Lithium and Chlorpromazine
Psychotropic Drugs
Developed in 1950 to treat mental illness
Drugs developed within 10 years of development?
MAIOs, Haloperidol, Tricyclics, Antipsychotics, and Benzodiazepines
What was the aim for psychopharmacology
decrease agitation, psychotic thinking, depression, shorten hospital stays, discharges to home
Supplemental Security Income (SSI) and Social Security Disability Income (SSDI)
Allowed those with mental illness to be more independent financially rather than relying on family (saved the state money)
Sigmund Freud
Father of psychoanalysis
Sigmund Freud: ID
reflects basic or innate desires such as pleasure-seeking behaviors, aggression, and sexual impulses. Seeks gratification, causes impulsive thinking, no regard to rules
Sigmund Freud: Superego
reflects morals and ethical concepts, values, parental and social expectations- opposite of ID
Sigmund Freud: Ego
balancing or mediating force between ID and Superego; mature and adaptive behavior (anxiety)
Transference
Displaced onto the therapist, attitudes, and feelings that the client experienced in other relationships (automatic and unconscious)
Countertransference
The Therapist displaces onto client from past
Erikson’s Development
Trust vs. Mistrust (infant);
Autonomy vs. Shame & Doubt (toddler);
Initiative vs. Guilt (Preschool);
Industry vs. Inferiority (school age); Identity vs. Role Confusion (adolescent); Intimacy vs. Isolation (young adult); Generativity vs. Stagnation (middle adult); Ego integrity vs. Despair (maturity)
Orientation Phase
Directed by nurse, involves engaging the patient in treatment, provides information, answers questions
Identification Phase
Begins when the patient works independently with the nurse, expresses feelings, feels stronger
Exploitation Phase
The patient will make full use of the services offered
Resolution Phase
Patient no longer needs professional services and gives up dependent behavior
Agonist
Increases effects of neurotransmitter
Encourages molecules to bind to that receptor
AKA: copycats because they mimic neurotransmitters
Antagonist
Block something from happening and reduce normal effects
4 Components of the Brain Stem
Midbrain, Pons, Medulla Oblongata, Nuclei CN III-XII
Serotonin
An important role in anxiety, mood disorders, and schizophrenia which is associated with delusions and hallucinations
*some antidepressants block serotonin reuptake
Efficacy
Maximal therapeutic effect that drug can achieve
Potency
The amount of drug needed to achieve the maximum effect
Tolerance
A gradual decrease in the action of a drug at a given time
Half-Life
Time it takes for half of the drug to be removed from the bloodstream
- Short half-life requires frequent dosing
- when drug is d/c it is 5 times its half-life to leave body
Toxicity
The point at which concentrations of the drug in the bloodstream are high enough to become harmful or poisonous to the body
Therapeutic Index
The ratio of the maximum nontoxic dose to the minimum effective dose
Off-Label Use
Drug that is used for a disease that differs from the one involved in the original testing and FDA approval
Black Box Warning
When a drug has serious life-threatening side effects, even if they are rare
*warning in box
Risk Evaluation and Mitigation Strategy
Required by the FGA if the drug has serious SE
*specific actions and safe guards are also required to govern the use of these drugs
Neuroleptic Malignant Syndrome (NMS)
Potentially fatal reactions to antipsychotics usually occurs within the first 2 weeks or after increase
S/S of NMS
Rigidity, High fever, Autonomic Instability (BP/ Diaphoresis/Pallor), Delirium
*often present as confused, mute, fluctuate between agitation and stupor
Risk Factors of NMS
Dehydration, Poor nutrition, Concurrent medical illness
Treatment of NMS
Stop antipsychotic and provide supportive care
Tardive Dyskinesia (TD)
Permanent involuntary movements commonly caused by long-term use of antipsychotics
*irreversible
S/S of TD
Involuntary movement of the tongue, facial and neck muscles, upper and lower extremities, grimacing
Treatment and Goals of TD
Administer vesicular monoamine transporter 2; prevention is key and keeping dosage low
Abnormal Involuntary Movement Scale
Standardized assessment tool to monitor for TD
Clozapine
Antipsychotic Med; produces few traditional side effects, has potentially fatal side effect of agranulocytosis; Develops suddenly with fever, malaise, sore throat, leukopenia
*Required to have weekly WBC and ANC x 6mon, then every 2 weeks x 6mon, then q4weeks
MAOI
Anti-Depressive (1950s; Caution with Hypertensive Crisis (Decrease Tyramine); Makes chemicals available in the brain that are decreased by enzyme; Side effects include sedation, insomnia, weight gain, dry mouth
Lithium
First Line agent in bipolar
normalizes reuptake of serotonin, norepi, acetylcholine, dopamine
- can be harmful to kidneys
SE: Nausea, hand tremors, diarrhea, anorexia, polydipsia, metallic taste
Normal Lithium
0.6-.12 mEq/L; levels above 1.5= toxic
S/S Lithium Toxicity
Severe Diarrhea, Vomiting, Drowsiness, Muscle Weakness, Lack of Coordination
Anxiolytics
Treatment of anxiety, insomnia, OCD, depression, PTSD, alcohol withdrawal
(benzodiazepines- GABA)
*Addictive
Anxiolytics Time Frame of Usage
No longer than 6 weeks at a time
Side Effects of Anxiolytics
Dependence, CNS Depression, Tolerance, Hangover Effects
Examples of Anxiolytics
Benzodiazepines:
Alprazolam (Xanax)
Lorazepam (Ativan)
Clonazepam (Klonopin)
Diazepam (Valium)
Chlordiazepoxide (Librium)
Inpatient Hospital Stay
Rapid Assessment; Stabilize Symptoms; Discharge Planning
*goals completed quick
*client-centered
Short Stay
Short term Care that quickly stabilize and are discharged
Long Term Care
Patients unable to be stabilized quickly and require additional treatment
*home like care
Clubhouse Model
Community based rehab that assists patients with daytime work, maintenance, support
Residential Settings
Patients that require more structure with supervision and specific services (many variety options)
Transitional Housing
Type of residential setting that allows patients to progress to independent living
Adult Foster Care
Type of residential setting; 1-3 clients in a family atmosphere which includes meals and social activities
Half Way House
Type of residential setting that temporarily placement that provides support as client prepares for independence
Group Homes
Type of residential setting that includes 6-10 residents who take turns cooking, and doing chores with some supervision (1-2 staff members)
Cognitive Behavioral Therapy
Aaron Beck; focuses on faulty thinking resulting in distress and/or problems
*therapist helps the patient be their own therapist
Dialectical Behavioral Therapy
Aaron Beck; CBT is designed to treat clients with borderline personality disorders who are chronically suicidal
*clients learn mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness
Free Association
An attempt to uncover the client’s true thoughts and feelings by saying a word and asking the client to respond quickly with the first thing that comes to mind
