Pyschosocial Issues Flashcards
dual diagnosis
the relationship of a set of symptoms, including behaviors, which are or resemble symptoms of a known psychiatric disorder
2 diagnoses create disabling conditions as comorbidity creates additional stressors
how does the onset of psychiatric symptoms following brain injury negatively impact recovery?
causes caregiver stress, may lead to premature termination of rehabilitation
patient discharged too early, crisis events occur
negatively impacts return to community and independence
T/F: those with severe brain injuries have higher rates of depression
FALSE: those with severe injuries found to have lower rates of depression, suggesting self-awareness plays a role in depression
what is the most common Axis I disorder for TBI patients
major depressive disorder
what are the most common Axis II disorders for TBI patients
avoidant, paranoid, schizoid personality disorders
pre-morbid alcoholism is linked to post injury ____
depression
depression alone tends to relate to ___ hemisphere injury
while co-occurring depression and anxiety tends to relate to ____ hemisphere injury
depression - left hemi
depression + anxiety - right hemi
major depressive episode criteria
2+ weeks of loss of interest/ depressed mood accompanied by at least 4 additional symptoms:
change in appetite, weight gin, decreased energy, feeling of worthlessness, suicidal ideation
2 risk factors associated with developing major depressive disorder (MDD) following TBI
socioeconomic status
premorbid psychiatric pathology
manic episode criteria
1+ week of noticeably elevated, expansive, or irritable mood with at least 3 additional symptoms: extremely amplified self-esteem decreased desire for sleep grandiose ideas distractibility risk activities
bipolar affective disorder 1 and 2 criteria
bipolar 1 - 1+ manic episodes
bipolar 2 - 1+ depressive episode followed by 1+ hypomanic episode
cyclothymic disorder
subtype of bipolar disorder, chronic fluctuating mood disturbance including both depressive and hypomanic states
panic disorder criteria
repeated panic attacks followed by worry about future attacks or changes in behavior related to the panic attack, accompanied by at least 4 somatic symptoms:
sweating, palpitations, trembling, nausea, chest pain, dizzy, chills, hot flashes
repeated panic attacks make individual anxious about more panic attacks which causes rise to level of panic disorder
schizophrenia criteria
6+ months characterized by minimum of 1-month phase of symptoms such as delusions, hallucinations, incoherent speech, catatonia, avolition
organic personality disorder
traditional diagnosis for individuals who develop personality disorder following TBI
most frequently reported personality disorders following TBI
avoidant, paranoid, schizoid
frontal lobe syndrome and diagnosis methods
presents with symptoms of other psychiatric disorders including depression, psychosis, mood disorders, etc. Unable to regulate emotions due to damage.
diagnose with EEG, neuropsychological testing, MRI scans
pseudobulbar affect (PBA)
aka emotional incontinence - prone to sudden, inexplicable, often inordinate episodes of crying or laughing. Commonly misattributed to psychiatric disorders. Individuals cannot understand why they are displaying such emotions
associated with TBI, stroke, Parkinson’s, MS, dementia
consumption of alcohol and illegal drugs and the use of prescription drugs exceeding the prescribed amount or use of another person’s prescription drugs
substance misuse
continued substance use despite health, psychological, or social consequences
substance use disorder
use of substances in a manner associated with higher risk of physical, mental, or social consequences and therefore represents public health concern
hazardous use (of substances)
criteria of high-risk drinking for men and women (who are healthy)
men - 4+ drinks per day or 14 drinks in a week
women - 3+ drinks per day or 7 drinks in a week
CAGE standardized assessment tool for alcohol abuse
C - “have you ever felt you should Cut down on drinking?”
A - “have people Annoyed you by criticizing your drinking?”
G - “have you ever felt Guilty about your drinking?”
E - “have you ever had a drink first thing in the morning to steady your nerves (Eye opener)?”
four quadrant model of substance misuse/abuse
describes various settings where people with TBI and substance misuse could receive treatment quadrants divided by whether TBI and substance misuse are severe: Quad I (lower left): acute medical setting, primary care Quad II (lower right, severe TBI): TBI rehabilitation Quad III (upper left, severe misuse): substance use disorder treatment setting Quad IV (upper right): specialized TBI and SUD services
T/F: all persons receiving TBI rehabilitation should be screened for risk of substance misuse
TRUE. All patients should be provided with education regarding harms associated with substance abuse after TBI
T/F: approximately 25% of people receiving SUD treatment have a history of at least 1 TBI
FALSE: actually 50%
what are 3 principles important for SUD providers providing treatment to persons with limited cognitive abilities?
assist individuals to compensate for unique learning style
provide direct feedback regarding inappropriate behavior
be cautious when making inferences about motivation based on observed behaviors (ex- unawareness deficits may be due to brain damage and not denial)
