PsychosocialTest4 Flashcards

1
Q

define anxiety

A
  • feeling of uneasiness, uncertainty, and helplessness
  • state of tension
  • associated with feelings of dread or doom
  • response to a real or imagined treat or stressor
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2
Q

what are the purposes for anxiety

A
  • warning of impending danger
  • increase learning
  • provides motivation
  • leads to in/effective and mal/adaptive behaviors
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3
Q

responses to anxiety occur on what four levels

A

mild
moderate
severe
panic

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4
Q

what are the types of anxiety

A

signal anxiety
anxiety state
anxiety trait

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5
Q

define signal anxiety

A

a learned response to an anticipated event

Ex: a cal student becomes nauseated during exams

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6
Q

define anxiety state

A

occurs when one’s coping abilities become overwhelmed and emotional control is lost
EX: emergencies, accidents, traumas

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7
Q

define anxiety trait

A

a learned component of the personality

EX: react with anxiety in relatively low stress situations

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8
Q

what are some physical symptoms of anxiety

A
muscle tension
fidgeting
headaches
problems with sleep
nausea
dizziness
sweating
increased HR
elevated BP
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9
Q

coping mechanics come in what 4 realms

A

physical
intellectual
spiritual
emotional

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10
Q

coping mechanism in the physical realm includes

A

efforts to directly face and handle the problem

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11
Q

intellectual coping mechanisms are aimed at what

A

making the threat less meaningful by changing one’s perception

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12
Q

spiritual coping methods include what

A

faith
prayer
ritual

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13
Q

emotional coping responses include what

A

crying

communicating or sharing one’s anxious feeling

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14
Q

common defense mechanism; dissociation

A

separation of emotions from situation; removal of painful anxieties from conscious awareness
Ex:a solider casually describes the battle in which he lost his leg

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15
Q

common defense mechanism; intellectualization

A

focusing of attention of technical or logical aspects of threatening situation
EX: a wife describes the details of nurse’s unsuccessful attempts to prevent the death of her husband

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16
Q

common defense mechanisms; projection

A

putting of one’s own unacceptable thoughts, wishes, emotions onto others
EX: a woman is afraid to leave her house because she knows ppl will riddle her

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17
Q

common defense mechanism; reaction formation

A

development of conscious attitudes and behavior patterns that are opposite to what one really would like to have
EX: a man with homosexual feelings, which he finds to be threatening, engages in excessive heterosexual activities

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18
Q

common defense mechanism; restitution

A

giving back to resolve guilt feelings

EX: a man argues with his wife and then buys her roses

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19
Q

common defense mechanism; suppression

A

removal of conflict by removing anxiety from consciousness

EX: a woman with a family history of breast cancer “forgets” her appointment for a mammogram

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20
Q

common defense mechanism; symbolization

A

use of an unrelated object to represent hidden idea

EX: a girl who feel insignificant draws a picture of her family in which she is the smallest character

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21
Q

common defense mechanism; undoing

A

inappropriate behavior that is followed by acts to take away or reverse action and decrease guilt and anxiety
EX: a man physically abuses his wife then cleans her wounds and nurses her back to health

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22
Q

what are the purposes of defense mechanisms

A

reduce or avoid negative states such as conflict, frustration, anxiety, and stress

  • used when on feels threatened
  • helps avoid negative emotional states
  • reduce uncomfortable negative emotions
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23
Q

what is a crisis

A

when one’s ability to cope with anxiety is overwhelmed

-defense mechanisms are no longer useful

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24
Q

what is bad about having too little or too much anxiety

A

too little=lack of attention or focus in important situation

too much=overwhelm and immobilize an individual. inability to accomplish important tasks

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25
Q

the causes of anxiety are a combination of what factors

A

biological
psychosocial
environmental

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26
Q

biological model; theory relating to anxiety

A

find a biological or physical basis for anxiety

  • role of neurotransmitters
  • result from the dysfunction of two or more neurotransmitters
  • inappropriately activated norepinephrine
  • hormonal imbalances, substance abuse, eating and sleeping disorders, headaches, fatigue
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27
Q

psychodynamic model; theories relating to anxiety

A

result of a conflict btw two opposing forces within an individual

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28
Q

interpersonal model; theories relating to anxiety

A

interactions with others.

childhood interaction resulting in negative outcomes

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29
Q

behavioral model; theories relating to anxiety

A

a learned response
when individual encounter a signal that reminds them of earlier anxious times
learn to react with anxiety

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30
Q

existential theory

A

result of a loss of life’s meaning

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31
Q

what are some examples of behavior that seem to soothe and lessen anxiety for young children

A

thumb sucking
nail bitting
hair pulling
rhythmic body movements

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32
Q

problems associated with anxiety in children include

A
compulsion
phobias
separation anxiety disorder
overanxious disorder
avoidance disorders
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33
Q

what is separation anxiety disorder

A

diagnosed when children are unable to be without their parents for any length of time

  • physical complaints include headaches, nausea, vomiting, nightmares
  • fear of death, animals, monsters, and harmful situations
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34
Q

in children; overanxious disorder

A
  • unrealistic levels of anxiety lasting longer than 6 months
  • worry about everything
  • happens when parents focus on overachievement and downplay their actual accomplishments
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35
Q

in children; avoidance behaviors

A
  • child refuses to cope with the anxiety-producing situation by ignoring it
  • reactions to divorce, death, or separation
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36
Q

adolescence who ineffectively cope with anxiety often express themselves with inappropriate behavior such as

A
running away from home
becoming angry
defiant
aggressive
manipulative
experimenting with drugs
engaging in high-risk behaviors
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37
Q

when adult anxieties are not successfully managed, what help problems can result

A
generalized or situational anxiety disorder
panic disorders
phobias
behavior addictions
obsession
compulsive activities
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38
Q

what are characteristics of anxiety in older adulthood. what are some behaviors indicating the presence of anxiety

A

often deny their anxiety
less likely to share feelings
-apathy, changes in eating, sleeping, ability to concentrate, impatience, fatigue

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39
Q

define anxiety disorder

A

exists when anxiety is expressed in ineffective or maladaptive ways and one’s coping mechanisms do not successfully relieve the distress

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40
Q

anxiety disorders are characterized by types. what are they

A
generalized
panic
phobic
obsessive-compulsive
behavioral
post-traumatic
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41
Q

describe generalized anxiety disorder

A
  • when an individual’s anxiety is broad, long lasting, and excessive
  • primarily a disturbance in the emotional area
  • eventually affects every other aspect of individual
  • worried and anxious more often than not
  • difficult to control their worries
  • occurs in person with IBS, headaches, sleep disturbances, substance abuse
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42
Q

what is generalized anxiety called in children, and how does it differ from adults

A

overanxious disorder of childhood

-worry about their school performance and social interactions while adults concentrate on worrying about everyday events

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43
Q

describe panic disorder

A

brief period of intense fear or discomfort

  • accompanied by various physical and emotional reactions
  • 1 to 15 minutes long
  • more common in women
  • separated/dived a
  • ages 24-44
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44
Q

what are the two kinds of panic disorder

A

those associated with agoraphobia and those that are not

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45
Q

what is agoraphobia

A

anxiety about possible situations in which panic attack may occur
avoid ppl, places, or events
-fear accompanies a sense of helplessness and embarrassment
-typically associated with public situations

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46
Q

treatment for panic disorders has what 3 goals

A

educate client about disorder

  • block panic attacks pharmacologically
  • assist clients in developing more adaptive ways of coping
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47
Q

define phobia

A
an internal fear reaction
involve specific situations or objects
-obsessive in nature
-tend to dwell on their object of fear to almost point of fascination
-immobilizing
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48
Q

what are some panic attack criteria

A

must have at least 4 symptoms and reach peak within 10 minutes

  • palpitations, pounding heart, fast HR
  • sweating
  • trembling/shaking
  • feelings of SOB
  • feelings of choking
  • CP or discomfort
  • nausea or abdominal distress
  • dizzy, unsteady, lightheaded or faint
  • derealization or depersonalization
  • far of losing control or going crazy
  • fear of dying
  • paresthesias
  • chills or hot flashes
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49
Q

what is the difference btw obsession and compulsion

A

obsession is a distressing persistent thought

compulsion is a distressing recurring behavior

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50
Q

summarize OCD

A
  • can begin early as 3
  • usually begin in adolescence
  • most common obsession relate to cleanliness, dirt, germs, aggressive and sexual impulse, health concerns, safety, order and symmetry
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51
Q

how is OCD treated

A

combination of drug and behavior therapy

-antidepressants and SSRI (selective serotonin re-uptake inhibitors)

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52
Q

what is traumatic stress reaction

A

series of behavioral and emotional responses following an overwhelming stressful event

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53
Q

what are important therapeutic interventions for clients with traumatic stress reaction

A

providing psychological stability, emotional support, advocacy

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54
Q

what is post-traumatic stress disorder

A

been exposed to a traumatic experience that was outside the realm of normal life experiences

  • intense fear, horror, helplessness
  • symptoms include flashbacks, anxiety, depression, and nightmares
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55
Q

how do you treat PTSD

A

drug therapy, mental health interventions, emotional support

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56
Q

what are three behavioral therapies used successfully in treating phobias

A

cognitive behavioral therapy
systematic desensitization
flooding

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57
Q

describe cognitive behavioral therapy

A

helps clients intellectually understand the ineffective behaviors used to cope with anxiety and replace them with more successful behaviors

58
Q

describe systematic desensitization

A

clients leant to cope with one anxiety-provoking stimulus at a time
step by step method
allows clients to develop more effective ways of perceiving their anxiety

59
Q

describe flooding

A
  • the opposite of desensitization

- rapidly and repeatedly exposes clients to the feared object or situation

60
Q

side effects of benzodiazepines on central nervous system and nursing interventions

A

dizziness, drowsiness, sedation, headache, tremors, depression, insomnia, hallucination
-ensure safety, prevent falls, assist with ambulation, use side rails. assess mental status routinely

61
Q

side effects of benzodiazepines on GI and nursing interventions

A
  • dry mouth, anorexia, nausea, vomiting, constipation, diarrhea
  • give med with food/milk. oral care. offer candy, gum, sips of water. monitor intake/output
62
Q

side effects of benzodiazepine on cardiovascular and nursing interventions

A
  • ECK changes, orthostatic hypotension, tachycardia

- asses BP, pulse. monitor complete blood count

63
Q

side effects of benzodiazepine on eyes, ears, nose, throat and nursing interventions

A
  • blurred vision, ringing in ears

- ensure safety

64
Q

side effects of benzodiazepines on integument and nursing interventions

A
  • itching, rash, dermatitis

- use tepid baths w/o soap. asses rash

65
Q

side effects of benzodiazepines on emotional and nursing interventions

A
  • feelings of detachment, irritability, increased hostility

- encourage social interactions, asses for loss of control

66
Q

long term effects of benzodiazepines and nursing interventions

A
  • increased drug tolerance, physical and psychological dependency, rebound anxiety and insomnia
  • drug dose is papered slowly
67
Q

side effects of antihistamines to treat anxiety

A

drowsiness, headache, think bronchial secretions, nausea, diarrhea, constipation

68
Q

side effects of SSRI antidepressants to treat anxiety

A

dizziness, drowsiness, diarrhea, dry mouth, urinary retention, low blood pressure when standing, high blood pressure, acute renal failure

69
Q

side effects of Buspirone (BuSpar, VanSpar) to treat anxiety

A

dizziness, headache, depression, insomnia, fast HR, blurred vision, nasal congestion, sweating, rash, weakness, chest congestion

70
Q

what are the 5 stages of illness

A
symptoms
sick role
medical care
dependency
recovery/rehabilitation
71
Q

stage one of illness, and what happens in this stage

A
  • symptoms

- when one becomes aware that something is not right

72
Q

stage 2 of illness, and what happens in this stage

A
  • the sick role
  • seeks to confirm illness
  • can support the presence of an illness, and assume the sick role, or deny the illness
73
Q

assuming the sick role serves what purposes

A
  • person is excused from everyday responsibilities
  • permission is given to rest and conserve energy for healing
  • social responsibilities of interacting with others are relieved
  • permission is given to focus on restoring health
74
Q

what is stage 3 of illness and what happens

A
  • medical care
  • person seeks medical intervention
  • professional confirms illness, provides treatment, informs individual of cause, course, and future
  • either accept diagnosis or deny the problem
75
Q

4th stage of illness and what happens

A
  • dependency
  • accepts the attentions of other
  • one must rely on the kindness and energies of others
  • relieved of obligation, allowed to be passive and dependent, expected to get well
76
Q

stage 5 of illness and what happens

A
  • recovery/rehabilitation

- can occur suddenly or slowly

77
Q

what are 5 behavioral and emotional changes associated with illness

A
anxiety
anger
denial
shock
withdrawal
78
Q

individuals who are hospitalized go through what 3 stages

A
  • overwhelmed=intensity of being separated from loved ones/left alone
  • stabilization=gradually gain the strength to reestablish some personal identity
  • adaptation=regained enough of a personal identity to adapt. energies are replenished
79
Q

what is the difference between internal and external loss

A

internal=more personal. include losses that involve some part of oneself
external=outside the individual. relate to objects, possessions, environment, loved ones, support

80
Q

define loss

A

a state in which something valued that was formerly present is changed or gone. Can no longer be seen, felt, heart, known, or experienced

81
Q

losses can be temporary, permanent, expected, unexpected. give explanation and example

A

temporary example=illness
permanent=forever. loss of arm
expected=old age.
unexpected=cancer diagnosis

82
Q

what is difference between maturational and situational loss

A

maturational=individual must give up something to gain a higher level of development
situational=response to external events. individual has no control over the event leading to loss

83
Q

at what age do most children have an adult concept of loss

A

9 or 10

84
Q

define grief

A

the set of EMOTIONAL REACTIONS that accompany a loss

85
Q

define mourning

A

the PROCESS of working through or resolving one’s grief

86
Q

define bereavement

A

the BEHAVIORAL STATE of thoughts, feelings, and activities that follow a loss

87
Q

what is the grieving process and name steps

A
a method for resolving losses and healing
denial
yearning
depression and identification
acceptance and recover
88
Q

what is the denial stage

A
feeling of shock
reject the loss
refuse to give up object/person
may not even acknowledge that a loss occurred
behave as if nothing has happened
89
Q

what is the yearning stage

A

reality of loss begins to be realized
becomes overwhelmed
griever falls apart

90
Q

what happens in the depression and identification

A

third stage
guilt and remorse
cope with painful void left by the loss
may withdraw from social interactions, engage in unhealthy behaviors, experience overwhelming loneliness

91
Q

what happens in acceptance and recovery stage

A

focus their energies toward the living

loss is a reality

92
Q

what is anticipatory grief

A

process of grieving before the actual event occurs.

allows individuals time to prepare for the loss

93
Q

what is unresolved grief

A

also termed dysfunctional grief/complicated bereavement
unhealthy or ineffective grief reactions
unable to shift their attention from their loss
unable to function effectively
there are two types

94
Q

what are the two types of unresolved grief

A

bereavement related depression

complicated grief

95
Q

describe bereavement related depression

A

feelings of despair and worthlessness overwhelm everything in life
changed in eating, sleeping, and activity levels
angry or hostile moods
inability to concentrate
more socially isolated
leads to suicide

96
Q

what is complicated grief

A

a persistent yearning for a person
impaired psychological functioning and disturbances of mood, sleep, and self esteem
intolerant of others
socially isolated

97
Q

how a person responds to and prepares for death depends on what two factors

A

the meaning of death

coping mechanisms used throughout life

98
Q

what are Elisabeth Kubler Ross’s five stages of dying. what are the 3 simplified stages

A
denial
anger
bargaining
depression
acceptance
-resistance, working, acceptance
99
Q

what is hospice

A

philosophy of care for people with terminal illnesses or condition and their loved ones

100
Q

what is the goal of hospice

A

make the remained of an individual’s life as meaningful and comfortable as humanly possible. focus of care is providing comfort.

101
Q

describe mood

A

prolonged emotional state that influences one’s whole personalty and life functioning

102
Q

possible causes of mood disorder

A
defects in the immune systems
genetics
biochemical imbalances
environmental and other stressors
childhood/adult experiences
social circumstances
103
Q

psychoanalytical theories believe what

A

see mood disorders as anger turned inward

104
Q

behaviorists view depression how

A

learned responses

105
Q

social theorists consider depression the result of what

A

faulty social interactions

106
Q

what is situational depression

A

aka acute depression

  • tied to a specific event or situation
  • traced to a recognizable cause
  • relieved once the stressors are removed or decreased
107
Q

emotions in children

A

-feelings of hopelessness, low self esteem
-take blame for every situation
-respond with irritability, tearfulness, sadness
-clinging and dependent
aggressive or disruptive behaviors
-changes in eating and sleeping behaviors

108
Q

emotions in adolescence

A
109
Q

depression in adolescence is usually related to what four factors

A

self esteem
loneliness
family strengths
parent teen communications

110
Q

define affect

A

outward expression of one’s emotions

111
Q

define mood disorder

A

a disturbance in the emotional dimension of human functioning
aka affective disorder

112
Q

define mania

A

emotional state in which a person has an elevated, expansive, and irritable mood
-accompanied by loss of identity, increased activity, and grandiose thoughts and actions

113
Q

mood disorders are divided into what two basic categories

A

depression

mania

114
Q

define dysthymia

A

moderate depression

115
Q

describe major depressive episode

A

depression severe and lasts more than 2 weeks

  • feelings of worthlessness, guilt, despair
  • eating and sleeping patterns are disrupted
  • feelings of powerlessness and helplessness
  • suicidal thoughts are entertained
116
Q

describe major depressive disorder

A
  • more than 2 years, routinely repeat
  • twice as often in adolescent girls and adult woman as in men
  • symptoms being at any age
  • average age is early 20s
  • low immune system functions
117
Q

describe dysthymic disorder

A
  • daily moderate depression that lasts for more than 2 years
  • chronically sad and self critical
  • consider themselves incapable and uninteresting
  • low energy levels, poor decision making skills, eating or sleeping difficulties
  • negative point of view of world
  • difficult to recognize and diagnose
118
Q

describe bipolar disorder

A

sudden and dramatic shifts in emotional extremes

has 3 stages

119
Q

describe 3 stages of manic behavior

A

hypomania-exaggerated sense of cheerfulness. outgoing. free of worry. euphoric.
mania=unstable high. angers quickly. flight of ideas. dresses inappropriately
delirium=extreme excitement, anger, elation. grandiose or religious delusions. disoriented. death from exhaustion may occur

120
Q

what is the difference btw bipolar 1 and 2

A

1=episodes of depression alternating with episodes of mania. delusions and hallucinations. more severe of the two
2=hypomanic moods that do not progress to full manic states

121
Q

define cyclothymic disorder

A

pattern that involves repeated mood swings alternating between hypomania and depressive symptoms
no periods of normal

122
Q

describe phases of treatment for depression

A

acute treatment=6 to 12 wks. reduce symptos and inappropriate behaviors
continuation=4 to 9 mo. prevent relapses into distresssing emotional states. clients educated and encouraged to try new coping behaviors
maintenance=indefinite. prevent recurrences

123
Q

antidepressants are divided into what groups

A
tricyclics
nontricyclics
monoamine oxidase inhibitors (MAOIS)
SSRIs
atypical antidepressants
124
Q

physical realm. nursing interventions

A

focus on personal hygiene, maintaining adequate nutrition, encouraging physical activity

125
Q

emotional real. nursing interventions for mood disorders

A

revolves around therapeutic relationship. acceptance and support. encouragement and emotional support

126
Q

intellectual realm. nursing interventions for mood disorders

A

need extra patience
nonjudgmental guidance
give instructions slowly and clearly

127
Q

define religiosity

A

believing that they have powers to communicate with god or become a spirit

128
Q

define health

A

embodying the whole person
state of well being
psychological realm is in balance with the physical realm
state of homeostasis

129
Q

what is physiological stress response mechanism

A

biological survival tool designed to provide the energy to fight opponents or flee from threat

130
Q

what are four major stress hormones

A

dopamine
epinephrine
norepinephrine
cortisol

131
Q

stress response theory

A

individuals are biochemically patterned to react to stress

132
Q

psychoanalytical theory of psychophysical disorders

A

focuses on the symbolism attached to a symptom or illness

133
Q

biological theory of organic weakness

A

states that every individual has one body system that is more sensitive than other systems

134
Q

all theories of psychophysical disorders have what in common

A
  • unconscious emotional conflict that increases anxiety is the basis for many psychophysical problems
  • development of physical symptoms is the result of attempts to lower anxieties
  • illness is real to the person
  • onset of the illness or problem is related to a stressful event
135
Q

what is the difference between primary gain and secondary gain

A

primary=symptoms reduce anxiety

secondary=assuming the sick role

136
Q

define somatization

A

feeling physical symptoms in the absence of disease or out of proportion to ailment

137
Q

somatoform disorder

A

demonstrate no object causes or physical dysfunctions for the signs and symptoms. person’s symptoms suggest the presence of a medical illness

138
Q

what are three feature that differentiate a somatization disorder from a medical problem

A
  • involvement of multiple organ systems
  • early onset and chronic condition with no physical changes over time
  • absence of any significant laboratory values
139
Q

conversion disorder

A

somatoform disorder in which the individual presents problems related to the sensory or motor functions

140
Q

what is a malingering individual

A

produces symptoms to meet a recognizable goal