psych exam 2 Flashcards by katie marrero

an abnormally persistently elevated mood, expansive mood, or irritable mood

mania

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what mood is the lack of restraints in expression, overvalued self-importance

expansive mood

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a distinct period of mania is called what

manic episode

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what is mood lability

rapid shifts in mood with little or no change in external events

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how long does hypomania last

4-7 days

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rank the levels of bipolar disorder

biolar 1 = most severe
bipolar 2
cyclothymic disorder

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what are some comorbid conditions associated with bipolar disorders

anxiety
panic
social phobia
substance use

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what are the goals of bipolar treatment

priority is safety
minimize and prevent either manic or depressive episodes
help the patient or family learn about the disorder and how to manage it throughout a lifetime

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pervasive and sustained emotion that colors ones perception of the world and how one functions in it

mood

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the afect of someone is how they express their mood… name the 5 affects

blunted
flat
inappropriate
labile
restricted or constricted

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a sad, irritable, or empty mood is present with somatic and cognitive changes that interfere with functioning

depressive disorder

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how many weeks of one or more depressive moods in nearly all activities is when its considered depressive disorder

2 weeks

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what are the 4 main symptoms of major depressive disorder

disruption in sleep, appetite, concentration, or energy
psychomotor agitation
excessive guilt or feelings or worthlessness
suicidal ideation

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what is the prime age range for depression

18-29

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what is the main co-occurring disorder associated with depression

anxiety

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name some risk factors of depression

-prior episode of depressions
- family hx
- lack of social support
- lack of coping abilities
- presence of life and environmental stressors
- current substance use or abuse
- medical and/or mental illness comorbidity

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what are the main treatment goals for depression

-reduce or control symptoms
-improve occupational and psychosocial function
-reduce likeliness of reocurance

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what are the 2 main nursing diagnoses for depression

imbalance nutrition & risk for suicide

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what is the major depressive disorder that has symptoms lasting for 2 years in adults and 1 year in children

persistent depressive disorder (dysthymia)

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what depressive disorder has recurring mood swings, feelings of sadness or sensitivity to rejection in the final week prior to menses

premenstrual dysphoric disorder

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what depressive disorder causes severe irritability and outbursts of tempter, begins before the age of 10 and is similar to pediatric bipolar disorder

disruptive mood dysphoric disorder

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whats the difference between NMS and SS

NMS: Caused by depleted dopamine due to antipsychotics, resulting in CNS hyperactivity (s/s: Hypertension, fever, sweating, agitation, disorientation, lead pipe muscle rigidity)

SS: too much serotonin from a combo of drugs or supplements (s/s- Mental status changes, agitation, ataxia, myoclonus, hyperreflexia, fever, shivering, diaphoresis, diarrhea)

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what are antihistaminic side affects

sedation and weight gain

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what are anticholinergic side effects

blurred vision
dry mouth
constipation
urinary retention
sinus tachycardia
decreased memory

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what is a state in which a person experiences hallucinations, delusions, or disorganized thoughts, speech, or behavior

psychosis

name the time frame of the below disorders: brief psychotic disorder schizophreniform schizophrenia

brief psychotic disorder = 2 weeks schizophreniform = 1-6 months schizophrenia = more than 6 months

name the 5 phases of schizophrenia in order

prodromal period acute illness period stabilization period recovery period relapses

what phase of schizophrenia is in the teenage years and looks like depression and isolation

prodromal period

what phase of schizophrenia is during ages 18-25 and the pt is actually having psychosis and needs medication and/or hospitalization

acute illness period

what are the positive symptoms of schizophrenia

distorted thoughts pacing delusions/ hallucinations agitated insomnia

what are the negative symptoms of schizophrenia

emotions and behaviors that should be present but are diminished being motivated eating speaking grooming socializing

what is involved in neurocognitive impairment

memory vigilance verbal fluency

repetition of another’s words that is parrot-like and inappropriate

echolalia

extremely detailed and lengthy discourse about a topic

Circumstantiality

absence of the normal connectedness of thoughts, ideas, and topics; sudden shifts without apparent relationship to preceding topics

Loose associations

the topic of conversation is changed to an entirely different topic that is a logical progression but causes a permanent detour from the original focus

Tangentiality

the topic of conversation changes repeatedly and rapidly, generally after just one sentence or phrase

Flight of ideas

stringing together words that are not connected in any way

Word salad

words that are made up that have no common meaning and are not recognizable

Neologisms

suspiciousness and guardedness that are unrealistic and often accompanied by grandiosity

Paranoia

a belief that neutral stimuli have special meaning to the individual, such as a television commentator who is speaking directly to the individual

Referential thinking

restricts thinking to the literal and immediate so that the individual has private rules of logic and reasoning that make no sense to anyone else

Autistic thinking

lack of abstraction in thinking; inability to understand punch lines, metaphors, and analogies

Concrete thinking

purposeless repetition of words or phrases

Verbigeration

use of words with similar meanings interchangeably

Metonymic speech

repetition of words or phrases that are similar in sound but in no other way, for example, “right, light, sight, might”

Clang association

overly and inappropriately artificial formal language

Stilted language

speaking as if the words are being forced out

Pressured speech

behaviors or attitudes that reflect rage, hostility, and the potential for physical or verbal destructiveness (usually comes about if the person believes someone is going to do them harm)

Aggression

inability to sit still or attend to others, accompanied by heightened emotions and tension

Agitation

psychomotor disturbances, such as stupor, mutism, posturing, or repetitive behavior

Catatonia

a hyperactivity characterized by purposeless activity and abnormal movements, such as grimacing and posturing

Catatonic excitement

involuntary imitation of another person’s movements and gestures

Echopraxia

behaving in a manner of a less mature life stage; childlike and immature behavior

Regressed behavior

repetitive purposeless movements that are idiosyncratic to the individual and to some degree outside of the individual’s control

Stereotypy

sustained attention to external stimuli as if expecting something important or frightening to happen

Hypervigilance

posture held in an odd or unusual fixed position for extended periods of time

Waxy flexibility

what are the 2 comorbidities associated with schizophrenia

substance abuse & depression

what is the main neurotransmitter associated with schizophrenia

dopamine hyperactivity (serotonin also)

what kind of stress leads to physiologic overload which leads to a negative impact on health

acute stress

what kind of stress is clearly linked to negative health outcomes

chronic stress

what kind of stress model is associated with development or exacerbation of mental illness

diathesis- stress model

what is the dynamic regulation of homeostasis

allostasis

what is the consequence of wear and tear on the body and brain that leads to ill health

allostatic load

increased levels of what results in stress

cortisol

what 2 factors determine if a person experiences a stress response

appraisal person-environment relationship

what is the consideration of demands, constraints, resources, and personal goals and beliefs

appraisal

what is the difference between primary and secondary appraisal

primary = evaluation of events as a threat, harm, or challenge secondary= explanation of the outcome of events

what 3 factors go into determining the person-environment relationship

1-values and goals 2- personality type (type a,b,c,d) 3- physical and social environment

what emotions occur when there is a threat to, delay in, or thwarting of a goal or a conflict between goals: anger, fright, anxiety, guilt, shame, sadness, envy, jealousy, and disgust.

Negative emotions

what emotions describe emotional reactions that are too ambiguous to fit into any of the preceding categories: confidence, awe, confusion, and excitement

nonemotions

what emotions are somewhat ambiguous: hope, compassion, empathy, sympathy, and contentment.

Borderline emotions

what emotions occur when there is movement toward or attainment of a goal: happiness, pride, relief, and love.

positive emotions

deliberate, planned, and psychological activity to manage stressful demands is called what

coping

what are the 2 types of coping

problem focused - changes the person-environment relationship emotion focused - changes the meaning of the situation

adaptation effects what 3 areas

healthy coping psychological well-being social functioning

the internal affective state that may or may no be expressed in overt behavior; if expressed, can be constructive or destructive

anger

excessive outwardly directed anger or suppressed anger

maladaptive anger

t/f anger is often a secondary emotion

true

these characteristic behaviors represent what type of anger expression: Feeling anxious when anger is aroused Acting as though nothing happened Withdrawing from people when angry Conveying anger nonverbally by body language Sulking, pouting, or ruminating

anger suppression

these characteristic behaviors represent what type of anger expression: Flying off the handle Expressing anger in an attacking or blaming way Yelling, saying nasty things Calling the other person names or using profanity Using fists rather than words to express angry feelings

unhealthy outward anger expression

these characteristic behaviors represent what type of anger expression: Discussing the anger with a friend or family member even if the provocateur cannot be confronted at the time Approaching the person with whom one is angry and discussing the concern directly Using “I” language to describe feelings and request changes in another’s behavior

constructive anger discussion

avoiding provoking stimuli, self-monitoring, stimulus control, response disruption, guided practice, and relaxation training are all what kind of anger interventions

behavioral interventions

what kind of anger intervention is for dysfunctional but nonviolent anger

psychoeducational intervention

the overt behavior intended to hurt, take advantage or control over someone verbally or physically is called what

aggression

the physical aspect of aggression means what

slapping or hitting things (not the person they're angry at & causing property damage

what aggression is when the frontal cortex doesnt rein in the amygdala resulting in behavior comparable to a "wild horse"

impulsive aggression

what aggression is premeditation, unrelated to person's pain

instrumental aggression

the use of strong force or weapons to inflict bodily harm to another in extreme aggression is called what

violence

all violence = aggression

NOT all aggression = violence

what is the name of the aggression-related gene

"warrior gene" monoamine oxidase A

what psychological theory is the suppression of drives

psychoanalytic theories

what psychological theory is the learned response to stimulus; frustration-aggression hypothesis

behavioral theories

what psychological theory is the participation in an environment that rewards aggression

social learning theory

name some characteristics of unit culture and staff behavior that predict patient violence

strict rules Lack of pt privacy or boundaries Strict authority Lack of patient control over the treatment plan Denial of patient requests or privileges Lack of meaningful and predictable activities Insufficient help with ADLs and other needs from staff Power struggles related to medications Failure of staff to listen or convey empathy

what are the 3 steps to managing imminent aggression and violence

1- de-escalation 2- PRN med administration and monitoring 3- avoidance of the use of seclusion and restraints

what occurs when there is a perceived challenge or threat that overwhelms the capacity of the individual to cope effectively with the event

crisis

what is a time-limited event triggering adaptive or nonadaptive responses to maturational, situational, or traumatic experiences

crisis

name the 3 types of crisis

developmental = during puberty situational = loss of job traumatic = death of friend

what is the intense, emotional reaction to the loss of a loved one; biopsychosocial response that often includes spontaneous expression of pain, sadness, and desolation

grief responses

what is the process of mourning and coping with the loss of a loved one beginning immediately after the loss but possibly lasting months or years

bereavement process

what are the 5 stages of grief

1- shock and disbelief 2- awareness of loss 3- conservation - withdrawal 4- healing 5- renewal

what are the 3 types of grief

uncomplicated (most common) traumatic (external factors make it worse) complicated (chronic mourning)

lithium patients need what

to be adequately hydrated and eat adequate sodium in their diets