streyffeler Flashcards
1
Q
diagnostic criteria of Adjustment disorder
A
- emotional/behavioral symptoms in response to stressor (need to start within 3 months of the stressor)
- Symptoms: (do not last more than 6 months) (need to be clinically signficant)
- marked distress that is disproportionate to stressor
- significant impairment in functioning
- elevated risk of attempted and complete suicide
- rule out MDD and acut stress disorder/PTSD
2
Q
common causes of adjustment disorder
A
job loss
sudden financial loss
end of relationship
death of loved one
natural disaster
overwhelming stress
multipe or recurrent stressors
3
Q
Relaxation response
A
- sit quietly in a comfortable position
- close yoru eyes
- deeply relax all your muscles, begining at your feet and progressing up to your face. keep them relaxed
- Breathe through your nose
- become aware of your breathing
- breath easily and naturally
- continue for 10 to 20 minutes
- when you are finish, sit quietly for several minutes, at first with your eyes closed and later with them open
- do not worry about whether you are successful in acheiving a deep level of relaxation
- maintain passive attitude and permit relaxation to occur at its own pace
4
Q
Risk factors for adjustment disorder
A
- may be underlying emotional vulnerability
- HIGHER the level of stress, the MORE LIKELY a disorder is to devleop, even in individuals with little vulnerability
- Stressors that REACTIVATE feelings or memories of previous stressful events.
5
Q
what are healthy coping strategies
A
- focus on the present moment (decrease anxious focus)
- diaphragmatic breathing –> generate parasymapthetic response
- Meditation
- get adequate rest (both sleep and vacations)
- Spend time outdoors
- have a pet
- EXCERCISE (BEST STRESS-MANAGEMENT TECHNIQUE
- improves mood
- improves body image
- lots of barrier to long-term, consistent implementation
- yoga and massage
6
Q
What is relaxation response effective against:
A
- Hypertension
- insomnia
- anxiety
- pain
- substance abuse
- reducing medication usage
7
Q
DSM-5 Definition of PERSONALITY DISORDER (PD)
A
-
enduring pattern of inner experience and behavior that:
- deviates markedly from the expectations of individuals culture
- pervasive and inflexible
- onset in adolecence or early adulthood
- Stable over time
- leads to distress or impairment
8
Q
Paranoid PD
A
-
Pattern of excessive distrust and suspicion of others
- sees other as having malevolent intent
- reads hidden derogatory or threatening meanings in neutral comments or events
- Reluctance to confide in others; excessive need for self-sufficiency; tend to be rigid and controlling
- Unable to forget and forgive insults or slights
- BE VERY OPEN about what you are doing and why (DON”T GET DEFENSIVE OR DISSMISSIVE)
9
Q
Schizoid PD
A
- neither desires or enjoy close relationships
- strong perference for SOLITARY ACTIVITES
- little interest in sexual activities
- insenstive to praise or criticism
- Appears cold, detached or unemotional
- Maintain a professional style and interest in their well-being
- respect privacy
- EXPLAIN the reasoning for advice
10
Q
Schizotypal PD
A
-
Discomfort with close relationships, lack of close friends or confidants
- ODD BELIEFS or MAGICAL THINKING
- odd perceptual experiecnes
- peculiar behavior or appearance
- social anxiety that trends toward paranoid fears
- AVOID CONFONTING the odd beliefs or behaviors and simply accept their reality
- if causing medical problem, confront gently
- screen for more florid forms of psychosis
11
Q
Antisocial PD
A
- Persistent disregard for the right of others
- repeatedly engaging in illegal actions
- consistent deceitfulness
- impulsivity and irresponsibility
- irritability
- Lack of remorse
- UNLIKELY TO FOLLOW RULES of clinician-patient relationship (they will try and manipulate you)
- SET and ENFORCE clear boundaires
- mindful of drug-seeking or malingering behavior
12
Q
Borderline PD
A
- desperation to avoid abandonment
- intense, unstable, all-good or all-bad relationships
- significant impulsivity
- frequent suicidality or self-injury (completed is 8-10%)
- reactive, unstable mood
- intense, poorly controlled anger
- RELATIONSHIP with the health care provider is also likely to be intense and either idealizing or devalueing
- AVOID RESCUING or ABANDONING (SET AND ENFORCE CLEAR BOUNDARIES)
13
Q
Histrionic PD
A
- Desire to be center of attention at all times
- often seductive or sexually provocative
- rapidly shifting emotions
- theatrical, exaggerated
- SUGGESTIBLE
- TAKE DRAMATIC NATURE of their communication into account when assessing symptoms (but avoid dismissing concerns)
- MAINTAIN CLEAR BOUNDAIRES; neither excessively formal nor too casual
14
Q
Narcissistic PD
A
- Sees self as superior and expects others to do the same, but self-esteem is very fragile
- only wants to associate with HIGH-STATUS people or institutions
- Strong sense of entitlement
- willing to use others to achieve own ends
- LACKS EMPATHY
- tends to be arrogant and Haughty
- AVOID CONFRONTING the ENTITLEMENT DIRECTLY
- instead, frame your suggestion with a statement about the patient deserving the best care possible
15
Q
AVOIDANT PD
A
- very strong fears of criticism and rejection that lead to avoidance of activites involving interpersonal contact
- NEED TO BE SURE s/he will be liked before entering into a relationship
- ongoign fear of shame or ridicule within intimate relationship
- sees self as inadequate, inept and inferior
- very reluctant to take risks or try new things
- PATIENT WILL THINK THEY DISLIKE YOU
- BE CALM, TRANSPARENT, REASSURING
- matter-of-fact, relaxed style is helpful
