Sean hood lectures

Question 1

kubler-ross model is commonly known as

Answer 1

the five stages of grief

Question 2

the 5 stages of grief is called

Answer 2

the kubler-ross model

Question 3

what are the 5 stages of grief

Answer 3

denial - temporary defence for the individual
anger - any individual that symbolises life or energy is subject to projected resentment and jealousy
bargaining - hope that the individual can postpone or delay the problem.
depression - silent, refusing visitors, spending much time crying and grieving. It is not recommended to attempt to cheer up a person in this stage, as it is important time for grieving and processing.
acceptance - individual comes to terms with the event

Question 4

telephone psychiatric referral structure is used when

Answer 4

calling a psychiatrist to refer a patient

Question 5

general heading of structure of telephone psychiatric referral

Answer 5

greeting
clarify relevance of consult
clarify intent of the call
headline summary
pause
meta formulation / synopsis
restate purpose of referral

Question 6

what are defences?

Answer 6

automatic psychological processes that protect the individual against anxiety and from awareness of internal or external dangers or stressors

Question 7

4 levels of defence mechanisms in Valliant’s classification

Answer 7

1. Psychotic (<5 years, adult dreams and fantasy)
2. Immature (3-15 years, PD, adult psychotherapy)
3. Neurotic (3-90 years, acute stress, neurotic dis.)
4. Mature (12-90 years)

Question 8

4 mature level defences

Answer 8

suppression
altruism
sublimation
humour

Question 9

suppression

Answer 9

emotions remains conscious but is suppressed

Question 10

altruism

Answer 10

suppressing the emotion by doing something nice for others

Question 11

sublimation

Answer 11

transmuting the emotion into a productive and socially redeeming endeavour
eg. ill start writing a book about how to cope with rejection

Question 12

humour

Answer 12

expressing the emotion in an indirect and humorous way

Question 13

5 defences on the neurotic level

Answer 13

denial (of internal reality)
repression
reaction formation
displacement
rationalisation

Question 14

denial (of internal reality)

Answer 14

denying that emotion exists
eg. ‘the rejection doesn’t bother me at all’

Question 15

repression

Answer 15

stuffing the emotion out of conscious awareness (unfortunately, the emotion typically returns to haunt the oppressor in unpredictable ways)

Question 16

reaction formation

Answer 16

forgetting the negative emotion by transforming it into it’s opposite
eg. ‘we’ve become so close since he cheated on me, he really is a wonderful person’

Question 17

displacement

Answer 17

displacing the emotion from its original object to something or someone else
eg. my boss really has been getting under my skin lately

Question 18

rationalisation

Answer 18

inventing a convincing, but usually false, reason why you are not bothered

Question 19

6 immature level defence mechanisms

Answer 19

passive aggression
acting out
dissociation
projection
splitting (idealisation/devaluation)
(Autistic) fantasy

Question 20

passive aggression

Answer 20

expressing anger indirectly and passively

Question 21

acting out

Answer 21

expression the emotion in actions rather than keeping it in awareness

Question 22

dissociation

Answer 22

dissociating instead of feeling the pain

Question 23

splitting (idealisation/devaluation)

Answer 23

defining the rejecting person as being all bad, verses having seen him as all good before the rejection, thereby transforming pain into anger and accusation

Question 24

(autistic) fantasy

Answer 24

withdrawal into excessive daydreaming rather than take effective action

Question 25

3 defence mechanisms on the psychotic level

Answer 25

denial (of external reality) distortion (of external reality) disavowal (of external reality)

Question 26

denial (of external reality)

Answer 26

eg. 'he never left me'

Question 27

distortion (of external reality)

Answer 27

eg. he never left me, he's just off on a business trip

Question 28

disavowal (of external reality)

Answer 28

eg. he never left me, in fact I never even met him!

Question 29

what is the difference between coping mechanism vs defence mechanism

Answer 29

Question 30

ways of describing Affect on MSE

Answer 30

congruent, reactive, range, intensity, mobility CRRIM

Question 31

affect

Answer 31

the patient's present emotional responsiveness, inferred from the patient's facial expression, including the amount and range of the expressive behaviour

Question 32

quality of affect

Answer 32

may be: dysphoric in depression euthymic (normal) elevated/euphoric in mania flat in schizophrenia labile (all over the place) irritable

Question 33

congrruency of affect

Answer 33

the affect may or may not be congruent with the mood (when the affect matches the mood)

Question 34

range of affect

Answer 34

may be within normal range, constricted, blunted or flat the normal range of affect should include variation of facial expression, tone of voice, use of hands, and body movement

Question 35

when affect range is 'constricted'

Answer 35

the range and intensity of expression are reduced

Question 36

when affect range is 'blunted'

Answer 36

emotional expression is further reduced

Question 37

when affect range is 'flat'

Answer 37

virrtually no signs of expression should be present patient's voice is monotonous and face should be immobile

Question 38

what things to point out regarding behaviour for MSE

Answer 38

engagement and rapport eye contact facial expression body language (eg. threatening, withdrawn, mannerisms) psychomotor activity (fidgeting, pacing, paucity of movement) abnormal movements or postures (involuntary movements, tremor, tics, lip-smacking, akathiasis, rocking)

Question 39

things to point out about speech on MSE

Answer 39

rate quantity tone volume fluency and rhythm

Question 40

rate of speech

Answer 40

pressure of speech: a tendency to speak rapidly, motivated by urgency, usually a manifestation of thought abnormalities such as flight of ideas

Question 41

quantity of speech

Answer 41

minimal or absent speech associated with depression excessive speech associated with mania or schizophrenia

Question 42

tone of speech

Answer 42

monotomous speech - associated with depression, schizophrenia and autism tremulous speech - associated with anxiety

Question 43

fluency and rhythm of speech

Answer 43

stammering or stuttering slurred speech - may occur in major depression due to psychomotor retardation

Question 44

mood represents

Answer 44

the patient predominant subjective internal state as described by them

Question 45

affect represents

Answer 45

immediately expressed and observed emotion eg. patiens facial expression and overall demeanour

Question 46

things to mention in regard to though content

Answer 46

delusions obsessions compulsions overvalued ideas suicidal thoughts homicidal/violent thoughts

Question 47

thought possession abnormalities

Answer 47

thought insertion thought withdrawal thought broadcasting

Question 48

thought insertion

Answer 48

a belief that thoughts can be inserted into the patient's mind

Question 49

thought withdrawal

Answer 49

a belief that thoughts can be removed form the patients mind

Question 50

thought broadcasting

Answer 50

a belief that other can hear the patients thought

Question 51

things to mention about perception on MSE

Answer 51

hallucinations pseudo-hallucinations illusions depersonalisation derealisation

Question 52

pseudo-hallucinations

Answer 52

the same as aa hallucination but the patient is aware that it is not real

Question 53

illusions

Answer 53

the misinterpretation of an external stimuli eg. mistaking a shadow for a person

Question 54

depersonalisation

Answer 54

the patient feels like they are no longer a true self and are someone different or strange

Question 55

derealisation

Answer 55

a sense that the world around them is not a true reality

Question 56

what to mention with regard to cognition

Answer 56

are they oriented to time, place, person attention span and concentration if an MMSE, AMTS, or ACE-III was performed

Question 57

risk factors for suicide

Answer 57

SADPERSONS sex (women > men attempts vs. success) age (teenagers and elderly) depression previous attempt ethanol rational thinking loss (10% schizophrenia) social support problems organised plan no spouse sickness (chronic illness)