Psych Test 1 Flashcards
What are thought disorders
Spectrum of disorders having several conmmon characteristics
What are the 5 things an individual can have with a thought disorder
Delusions
Hallucinations
Disorganized thinking and speech
Disorganized or abnormal motor behaviors
Negative symptoms
Positive symptoms
Added to - symptoms that shouldn’t be there
- delusions
Hallucinations
Altered speech patterns
Negative symptoms
“Normal things” a person should have but are taken away
Think 6 A’s
What are the 6 A’s of negative symptoms
Anhedonia - lack of pleasure
Flat affect - lack of expression
Apathy - lack of interest
Anergia - lack of energy
Alohia - lack of speech
Avolition- lack of motivation
Delusional disorder
Delusion is present
- explain delusion type/ characteristics
Asociality
Lack of interest in social interactions
Anhedonia
Lack of pleasure
Apathy
Lack of feeling , emotion , or interest
Avolition
Lack of motivation
Alogia
Lack/ decrease of speech
- symptom of schizophrenia
Hallucinations
False sense of perception
- any of the senses
Brief psychotic disorder
Sudden onset of at least one
Delusions / hallucinations/ disorganized speech / catatonic behavior
- more common in females
Schizophreniform disorder
Looks just like schizophrenia, but lasts less than 6 months
- may have social/ occupational impairments
What is schizoaffective disorder
Link b/w bipolar / mood disorders and schizophrenia/ thought disorders
How does schizoaffective disorder affect
How person expresses mood
Why does early onset diagnosis of schizophrenia lead to poor prognosis?
Because younger people do not have frontal lobe development and have not yet formed coping strategies
What are safety considerations with auditory hallucinations?
Ask if they are command hallucinations
What is the cause of schizophrenia?
No one cause!!!
Genetics
abnormalities in your translators - dopamine and glutamate
Structural abnormalities - atrophy of cerebellum enlarged ventricle, reduction of size of certain brain regions
How is schizophrenia diagnosed
Mental status exam for cognition
Psychiatric history from family/past medical records
- Careful, clinical observation
Physical exam to rule out in Medical causes such as substance induced psychosis and mood
- Vitamin deficiencies, vitamin D in first year of life in miles
Interventions for delusions
Ask
Be open and honest/nonjudgmental
Remember, it is real to the client
Encourage expression of feelings
If needed, set limits
Provide structure as needed
Acknowledg
Interventions for hallucinations
Monitor for cues and assess -
Ask if they are commands ?
Intervene, if needed
Decree stimuli
Limit therapeutic touch
Redirect if needed
Provide structure like set schedules
What are prognosis factors for schizophrenia?
Play or sudden disease onset
Female
Good pre-illness
Minimal cognitive impairment
Early inconsistent treatment
Family history of mood disorders
What are cool occurring diseases that may occur with schizophrenia?
Substance use disorder
Anxiety and depression
Cardiovascular disease
Metabolic syndrome
Is affected regarding glutamate that can cause schizophrenia
Alterations in glutamate that is associated with cognitive symptoms, memory/learning and breakdown of dope mean
- Can you play a role in structural brain abnormalities
5150
72 hour involuntary hold
5250
14 Involuntary hold
Common side effects from anti-psychotic meds
Tremors or muscle rigidity
Decrease respiration, leading to slurred speech
The neurotransmitter dopamine
Reward
D - determination
O - obsession
P - pleasure
- fine motor movement
Integration of emotions/ thoughts
Decision making
Stimulate hypothalamus
The frontal cortex is mostly affected by which neurotransmitter
Dopamine
How do antipsychotic drugs affect dopamine
They block dopamine, causing a Decrease, so there is a Decrease and determination/obsession/pleasure/motor function
Neurotransmitter norepinephrine
Stress hormone
N- no hesitation
O - on alert
R - recall memory
Typical antipsychotic meds
Works on positive symptoms
- d2 antagonist ( dopamine) going to lower it
Symptoms of typical antipsychotic meds
Sedation
Anti cholinergic effect
Orthostatic hypotension
Eps: movement side effects
Weight gain
Eps
Blockage of d2 receptors in motor areas cause extra pyramidal side affects
- acute dystonia - contractions
First gen ( typical ) antipsychotic meds
Chlorpromazine (cpz/ Thorazine)
Haloperidol
Fluphenazine (prolixin)
What typical antipsychotic is good for emergency and has a long acting form that is injected
Haloperidol (Haldol)
What 2 meds are good for psychosis happening now
Chlorpromazine
Haloperidol
What is the problem with chlorpromazine and haloperidol
Patient who takes for long time are known to have more eps, neck muscle seizing
2nd gen atypical antipsychotic meds
Aripiprazole
Olanzepine ( zyprexa)
Ziprasidone ( geodan)
Risperidone ( risperidal)
How do atypical antipsychotic meds work
Work for positive and negative symptoms
- work on neurotransmitters
Why are typical antipsychotics favored over typical antipsychotic
Have less likely to produce eps including tar dive dyskinesia and they target both positive and negative symptoms
Symptoms of atypical antipsychotic meds
Increase metabolic syndrome
Weight gain
Hyperglycemia/ hyperlipidemia
Poor temp recognition
Gi upset
Dry mouth/ excessive salivation
Clang association
Choosing words based on sounds
- rhyme
Neologism
Words that have meaning to patient but different non existent to others
- made up words
Affective blunting
Reduced or constricted affect - external expression of emotion
Anosognosia
Inability to see one has a problem/ Ill
Echolalia
Repetition of words
“Echos”
Circumstantiality
Talk with excessive and unnecessary detail but eventually gets to point
Tangentiality
Goes on a tangent or wanders off topic
Pressured speech
Urgent or intense speech - Talks really fast
Flight of ideas
Moving rapidly from one thought to the next
Making it difficult to follow along
Symbolic speech
Using words based on what they symbolize not what they mean
- demons are sticking needles in me = feeling pain
