psych week 1 Flashcards
Peplau (Peplau was aware)
Peplau (Nurse vs. friend roles) - be aware of your thoughts and feelings about patients. be empathetic, not sympathetic. focus on the patient - don’t tell them about your break up - focus on them.
one of the best ways to demonstrate respect is
with empathy
information giving
listener determines that client would benefit from concrete data thatthe listener has.
information giving can be useful
can be used to explain technical procedures, lab results, etc.
can be used to communicate resources the client mayfind useful, e.g. clinics, childcare centers, etc.
be careful not tso turn time with client into a lecture.
schizo - after 10 years
after 10 years, 25% fully recover, 25% improve, 25% need extensive help, 15% in and out of hospital. 10% die - cause of death is suicide.w
when does schizo develop for men and women?
Males - late teens, women late 20s early 30s.
Schizophrenia results in disturbances in (PTA is schizo)
thought processes, perception, and affect.
how many ppl develop schizo?
Approximately 1 percent of the population will develop schizophrenia over the course of a lifetime.
4 phases of schizo (just numbers)
I - IV
phase 1 - schizo - and what else?
The Prodromal (Prepsychotic) Phase: In this phase, the individuals are socially withdrawn, and have behavior that is peculiar or eccentric. Whether or not to intervene here pharmacologically is a hot area of research. Possible profalycitic meds.
phase 2 - schizo (and what is a big concern here?)
Acute: In the active phase of the disorder, psychotic symptoms are prominent. These include delusions, hallucinations, and impairment in work, social relations, and self-care. Often, safety is a big concern.
phase 3 - schizo
Stabilization: Symptoms are diminishing and pt is recovering. May be living at an ADU or L-facility.
phase 4 - schizo
Maintenance Phase: Pt is at baseline. Symptoms are greatly reduced, similar to the prodromal phase, or have disappeared. May be living independently.
schizo - Genetic Influences - what % is genetic?
A growing body of knowledge indicates that genetics play an important role (65-80%) in the development of schizophrenia. something turns on the genes - marijauna now bc it’s so much stronger. a little more common in males. females do a little better. may be more developmental for males, and more degenerative for females. hormones play a part.
schizo - Biochemical Influences (what hormones)
One theory suggests that schizophrenia may be caused by an excess of dopamine dependent neuronal activity in the brain. Abnormalities in the neurotransmitters norepinephrine, serotonin, acetylcholine, and gamma-aminobutyric acid, glutamate and cholecystokinine have also been suggested.s
schizo - Physiological Influences.
Several physiological factors have been implicated, including viral infection, brain abnormalities, and birth trauma.
schizo - Psychological Influences - when do first breaks happen?
“First breaks” (from reality) and relapses often occur during times of increased stress (e.g. leaving home to go to college).
schizo - Environmental Influences (your income is your environment)
Factors associated with lower SES (chronic poverty, high crime) have been linked to the development of schizophrenia…“downward drift” theory? (ppl who are schizo are more likely to be poor)
schizo - The Stress-Diathesis Model (stress the combo)
Schizophrenia is likely the result of a combination of psychological and environmental influences on an individual who is biologically vulnerable to the illness (could be starvation – concentration camp)
Schizotypal Personality Disorder.(frank is not typical)
Bizarre behavior and suspiciousness, but no frank psychosis. To be discussed more during lecture on Personality Disorders.
Delusional Disorder (delusional break in)
Nonbizarre delusions, without other sxs. they have dilusions, just not that bizarre. ie - house is being broken into, live in a bad neighborhood.
Brief Psychotic Disorder - how long do they last? (briefly one month)
Sudden onset of psychotic symptoms following a severe psychosocial stressor. Symptoms last less than one month, and the individual returns to the full premorbid level of functioning. ***not uncommon to go onto develop schizophrenia. higher risk for schizo.
Substance-Induced Psychotic Disorder - what drugs (and the weird one)
The presence of prominent hallucinations and delusions that are judged to be directly attributable to the physiological effects of a substance. drugs, alcohol, or medication. steroids. malaria drugs. stimulants. marjiuana, more than even psychedelics.
Schizophreniform Disorder (formed in 1 - 6 months)
same symptoms as schizophrenia with the exception that the duration of the disorder has been at least 1 month but less than 6 months. schizophrenia is more than 6 months.
Schizoaffective Disorder
Schizophrenic symptoms accompanied by a strong element of symptomatology associated with the mood disorders, either mania or depression (and psychotic symptoms).
euthymic
(normal mood)
Psychosis or Catatonia Associated with other medical conditions - what diseases (WALE on the psychosis)
Symptoms of this disorder include prominent hallucinations and delusions that can be directly attributed to a general medical condition. ie - wilson’s disease, autoimmune, lupus, encephalitis.
Psychosis or Catatonic Disorder Not Otherwise Specified - what is the prognosis? and how does it resolve?
Psychotic and/or catatonic symptoms that don’t yet meet diagnostic criteria for any of the above disorders. more likely to spontaneously resolve.
POSITIVE SYMPTOMS - and treatment?
reflect an excess or distortion of normal functions, such as AH, delusions and disorganized thinking, and are thought to have a relatively good response to treatment. outwardly obvious, hallucinations.
Thought Content
Thought Content (what a person is thinking)
thought content - dilusions - how many ppl have them?
Delusions (false personal beliefs) 75% of people with schizophrenia experience delusions
thought content - Erotomanic
The individual believes that someone, usually of a higher status (famous person), is in love with him or her.
thought content - Grandiose - common with what disorder? (I’m effectively grandiose)
Irrational ideas regarding own worth, talent, knowledge, or power. (common w/ schizoaffective disorder) you know someone famous.
thought content - Jealous.
Irrational idea that the person’s sexual partner is unfaithful.
thought content - Persecutory.
most common*** The individual believes he or she is being malevolently treated in some way.
thought content - Somatic (somatic pregnancy)
(body) The individual has an irrational belief that he or she has some physical defect, disorder or disease. convinced you have HIV. pregnant when they’re not - older women or males.
thought content - Religiosity
(excessive demonstration or obsession with religious ideas and behavior). this would cause an impairment of function.
thought content - Paranoia
(extreme suspiciousness of others) really common.
thought content - Ideas of Reference (they’re referencing me)
(false belief that one is the subject of attention by other people or the media).
Thought Process/Form (and abbreviation)
(how a person is thinking) abbreviated TP**
Thought Process - Associative looseness (and another term for it)
(shift of ideas from one topic to another) LOA - abbreviation. person is shifting as they are talking, one topic to another. also referred to as derailment. very common with schizo. don’t pretend like you understand when you don’t. pick out one part that did make sense. I’m having a hard time following, but I don’t understand. You mentioned…
Thought Process - Neologisms (Neo is made up)
(made-up words that have meaning only to the individual who invents them) rare.
Thought Process - Concrete thinking (concrete, but not sarcastic)
(literal interpretations of the environment). common with schizo and autism. can’t understand sarcasm. can’t understand abstract.
Thought Process - Clang associations
(choice of words is governed by sound, often rhyming)
Thought Process - Word salad
(a group of words put together in a random fashion)
Thought Process - Circumstantiality (these details are circumstantial)
(a delay in reaching the point of a communication due to unnecessary and tedious details). goes off on extra details, but do get to the point.
Thought Process - Tangentiality
(unable to get to the point of communication due to introduction of many new topics). loose association and tang interchangeable.
