psych - violence and sexual assault Flashcards

1
Q

Violence accepted within a family often leads to a perception in the children that this is

A

appropriate behavior (transgenerational)

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2
Q

CPS/APS can force legal investigations only with

A

children and dependent adults.***we can’t report independent adults

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3
Q

With non-dependent adults we can only:

A

inform clients of their rights
refer them to DV shelters/help them create safety plans
try to alleviate their fears of leaving the abuser/getting help.

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4
Q

GHB - onset

A

GHB (gamma-hydroxybutyrate) – legal by prescription. Onset within 20 minutes. used for narcalpsy. will be out of system fast, so hard to prosecute.

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5
Q

Rohypnol

A

(a potent BZD) – illegal. Onset within 30 minutes. short half-life.

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6
Q

Ketamine

A

Ketamine – legal anesthetic. Onset within 20 minutes. Duration an hour or less.

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7
Q

Rape-trauma syndrome

A

Similar symptoms to PTSD (covered with anxiety disorders). startle reflex, nightmares.

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8
Q

Physical assessment

A

Bilateral, often symmetric bruises
Multiple bruises/scars/fractures of different ages
Bruises/scars/lacerations in genital areas
Anxiety/fear around parents/caretakers/partners
Age-inappropriate hypersexuality/sexual acting-out in children
Explanations of wounds that change or are inconsistent with objective evidence
Unexplained malnutrition, poor wound healing, failure to thrive, poverty

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9
Q

Tension-building stage –

A

minor incidents of abuse that both perpetrator and victim rationalize as acceptable. Substance misuse is a common method for dealing with this.

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10
Q

Acute battering stage –

A

Brutal beatings.

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11
Q

Honeymoon stage –

A

Perpetrator remorseful and ‘loving.’ Victim feels needed and believes perpetrator’s promise

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12
Q

cardiomyopathy - which drugs

A

(stimulants and alcohol)

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13
Q

Substance Use Disorder:

A

Maladaptive use of drugs leading to impairment of social, physical or occupational functioning

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14
Q

Addiction

A

primary, chronic disease of brain reward, motivation, memory and related circuitry (i.e. brain dysregulation, esp in the reward pathway)

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15
Q

Cross-tolerance

A

the development of tolerance to one substance as a result of using another substance of the same class. higher dose of morphine for surgery for addict, ALSO, benzos for alcoholics - both acting on gaba so high doses of benzos.

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16
Q

theories of addiction - biology

A

genetic predisposition, physiological response (liver enzymes) - how ppl metabolize substances. asians lack enzyme that breaks down alcohol - then it builds up and makes them sick, so they don’t want to drink. or native americans who get addicted.t

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17
Q

theories of addiction - Psychological

A

low self-esteem, low frustration tolerance

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18
Q

theories of addiction - learning

A

environmental, peer pressure, positive experience w/ drugs and alcohol, family

19
Q

Ritalin for what? and 2 surprising ones

A

Rx for ADHD, narcolepsy, refractory depression

20
Q

stimulant withdrawals - how long

A

w/d sxs peak 24-72 hours, last 5-7 days

21
Q

coke withdrawals

A

(Effects and withdrawal sxs similar to amphetamines, but begin earlier

22
Q

MDMA - MOA

A

(“ecstasy,” “E”) rave drug, seratonergic.

23
Q

MDMA - risk

A

risk for hyperthermia

24
Q

MDMA - longterm use

A

long-term and/or heavy use may cause depression (destruction of serotonin neurons) may cause treatment resistant depression
less frequent use can be therapeutic

25
Q

alcohol - harder on men or women?

A

more serious health effects in women, ex. GI, liver

26
Q

alcohol - thiamine

A

thiamine deficiency (resulting in Wernicke and Korsakoff syndromes - language deficiets)

27
Q

alcohol withdrawal - early symptoms

A

(early signs) anxiety, tremor, N/V, HA, elevated BP, pulse

28
Q

alcohol withdrawal - late or severe symptoms

A

VH (visual hallucinations), TH (tactile hallucinations) (formication - crawling), (less common) AH, illusions, disorientation, seizures (can turn into status epiliticus), delirium tremens (DTs)

29
Q

how long do alcohol withdrawals last?

A

peak sxs occur 24-72 hours after last drink, last 5-7 days

30
Q

when do alcohol withdrawals start?

A

8-12 hours later

31
Q

alcohol withdrawals and water

A

push fluids - 2-4 liters of water

32
Q

alcohol withdrawal - how often to check VS?

A

frequent VS - every 4 hours

33
Q

Sedatives, Hypnotics and Anxiolytics

A

Barbituates (e.g. Phenobarbital), Barbituate-Like Hypnotics (e.g. Quaaludes), Carbamates (e.g. Meprobomate), Benzodiazepines (e.g. Xanax, Valium, Klonopin, Ativan)e

34
Q

effects of sedatives

A

decreased coordination, ataxia, double vision, respiratory depression, seizures, coma

35
Q

sedatives - withdrawal - high potential for what?

A

high suicide potential
high addiction potential
Withdrawal Sxs: similar to ETOH w/d sxs, intense craving

36
Q

hallucinogens - VS

A

elevated

37
Q

PCP - in the hospital -give what?

A

↓stimuli, may give Haldol or Ativan

38
Q

weed - Withdrawal sxs:

A

more psychological (irritability, anger, depression), but also can cause insomnia, abdominal pain, diaphoresis, HA, fever, chills

39
Q

labs

A

CBC, LFT, BAL (blood alcohol level), U-Tox

40
Q

pts w/ PSA often have

A

problems in every area of their life. Assess which drugs they have been using, quantity and frequency.

41
Q

Tx for codependence:

A

accept powerlessness, meet own needs, must grieve codependence role loss, Codependence Anonymous groups

42
Q

Risk for injury

A

(this would be withdrawal***): fall, sz, DTs, trauma, assault

43
Q

Acknowledge

A

feelings of guilt, hopelessness, anger, shame

44
Q

ask the pt if

A

they have ever been clean and sober? and how for long?