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Mental health exam 2 > Trauma and Stressor-related disorders > Flashcards

Trauma and Stressor-related disorders Flashcards

1
Q

What are individual traumas/stressors?

A
  • abuse
  • illness
  • victim of crime (robbery, etc.)
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2
Q

What are group traumas/stressors?

A
  • War/terrrorist attack
  • natural disaster
  • community loss (death of prominent citizen)
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3
Q

What are the characteristics of stress/trauma?

A
  • poor coping
  • difficulty managing stress
  • emotional difficulties
  • difficulty resuming activities of daily life
  • other symptoms: anxiety, insomnia, grief
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4
Q

What are psychiatric problems related to trauma/stress?

A
  • adjustment disorder
  • depression
  • complicated grieving
  • acute stress disorder
  • posttraumatic stress disorder
  • dissociative disorder
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5
Q

a disturbing pattern of behavior demonstrated by someone who has experienced, witnessed, or been confronted with a traumatic event such as a natural disaster, combat or an assault

A

PTSD

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6
Q

What occurs when a person is experiencing PTSD?

A
  • Intense memories of the trauma
  • Dreams/nightmares
  • Flashbacks
  • Intense, recurrent, intrusive thoughts
  • Emotional numbing
  • Increased irritability
  • Hyperarousal
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7
Q

What are the three major elements of PTSD?

A
  • Dreams or intrusive, recurrent thoughts of the trauma
  • Emotional numbing (feeling detached from others)
  • Hyperarousal (being on guard, irritable) symptoms that arise from high levels of anxiety, including insomnia, irritability, anger, outbursts, watchfulness, suspiciousness, and distrustfulness
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8
Q

event that occurred <3 months

A

acute stress disorders

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9
Q

event occurred >3 months ago

A

PTSD

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10
Q
  • chronic in nature with periods of exacerbation during increased stress
  • can lead to other psychiatric disorders such as depression, anxiety, and substance abuse.
A

PTSD

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11
Q

a group of symptoms, such as stress, feeling sad, or hopeless, and physical symptoms that occur following a stressful life event; the reaction is stronger than would be expected for the event that occurred

A

adjustment disorder

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12
Q

occur before the age of 5 years in response to the trauma of child abuse or neglect, called grossly pathogenic care. The child shows disturbed, inappropriate social relatedness in most situations.

A

Reactive attachment disorder (RAD) and Disinhibited social engagement disorder (DSED)

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13
Q

exhibits minimal social and emotional responses to others, lacks a positive affect, and may be sad, irritable, or afraid for no apparent reason

A

reactive attachment disorder

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14
Q

exhibits unselective socialization, allowing or tolerating social interaction with caregivers and strangers alike. They lack the hesitation in approaching or talking to strangers evident in most children their age

A

Disinhibited social engagement disorder (DSED)

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15
Q

Risk factors for PTSD

A
  • Directly involved in the traumatic event
  • Experiences of physical injury
  • Loss of loved one(s)
  • Lack of social supports
  • Pervious psychiatric history or personality factors
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16
Q

Adolescents suffering from PTSD have increased risk for the following:

A 
Suicide
Substance abuse
Poor social supports
Academic problems
Health concerns
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17
Q

What are some PTSD treatment options?

A
  • Psychotherapy (individual or group)
  • Medications (antidepressants, anxiolytics, sleep aids)
  • Self-help groups
  • Exposure therapy
  • Relaxation techniques
  • Adaptive disclosure
  • Cognitive processing therapy
  • Mental health promotion
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18
Q

A subconscious defense mechanism used to prevent recognition of a horrific or traumatic event
*** phenomena involves detachment from realit- rather than a loss of reality as in psychosis

A

dissociation

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19
Q

*This allows the person to forget or remove himself or herself from the painful situation or memory of the situation

A

dissociation

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20
Q

how is dissociation characterized?

A

Disruption in integration disorders use dissociation, a defense mechanism, pathologically and involuntarily

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21
Q

What are the types of dissociative disorders?

A
  • Dissociative amnesia
  • Dissociative identity disorder (formerly multiple personality disorder):
  • Depersonalization/derealization disorder:
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22
Q

The client cannot remember important personal information

A

Dissociative amnesia

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23
Q

The client displays two or more distinct identities or personalities

A

Dissociative identity disorder (formerly multiple personality disorder)

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24
Q

The client has a persistent or recurrent feeling of being detached from his or her mental processes or body

A

Depersonalization/derealization disorder

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25
Q

Dissociative disorder leads to disturbance in the following

A

*Relationships
*Ability to function (activities of daily living)
*Ability to cope
People with PTSD often experience dissociative symptoms

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26
Q

Treatment options for dissociative disorder

A

Individual therapy
Group therapy
Focus in therapy is on reassociation
Medications (antidepressants, anxiolytics)

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27
Q

What are the goals of treatment for dissociative disorder?

A
  1. Improve quality of life
  2. Improve functional abilities
  3. Decrease symptoms
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28
Q
  • Can range from passive to angry, frightened, agitated, hostile
  • Experience nightmares, flashbacks, intrusive thoughts, hallucinations, self-destructive thoughts, fantasies
  • memory gaps; poor decision making
A

dissociative disorder

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29
Q

What are the outcome goals for dissociative disorder?

A
  • Refer to patient as “survivor” rather than “victim”
  • Identification of flashback triggers
  • Encourage journaling of feelings
  • Utilize distractions and relaxation techniques
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30
Q

Maladaptive or Dysfunctional Personality Traits

A 
Irresponsible, not accountable for own actions
Risk-taking, thrill-seeking behaviors
Mistrust
Exhibitionism
Dependency
Eccentric perceptions
Negative behavior toward others
Anger and/or hostility
Irritable/labile moods
Lack of guilt, remorse or emotionally cold, and uncaring
Impulsive, poor judgment
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31
Q

is characterized by a pervasive pattern of depressive cognitions and behaviors

A

depressive behavior

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32
Q

is characterized by a negative attitude and a pervasive pattern of passive resistance to demands for adequate social and occupational performance

A

passive-aggressive behavior

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33
Q

Temperament (harm avoidance, novelty seeking, reward dependence, persistence)

A

biologic theories

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34
Q

Character
Self-directedness (responsible, goal oriented)
Cooperativeness (integral part of society)
Self-transcendence (integral part of the universe)

A

Psychodynamic theories

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35
Q

Treatment for personality disorders?

A
  • psychopharmacology

* group, individual therapies

36
Q

Cognitive-perceptual distortions;antipsychotics
Affective symptoms and mood dysregulation; mood stabilizers and lithium
Aggression and behavioral dysfunction; anticonvulsants and mood stabilizers
Anxiety;

A

Psychopharmacology (symptom focused)

37
Q

Examples of group, individual therapies?

A

Cognitive-behavioral therapies

Dialectical behavior therapy (borderline personality disorder)

38
Q

Clinical picture: pervasive mistrust/suspiciousness; use of projection; conflict with authority
Nursing interventions: formal, business-like approach; involvement in plan of care; idea validation before action

A

paranoid personality disorder

39
Q

characterized by a pervasive pattern of detachment from social relationships and a restricted range of emotional expression in interpersonal settings

A

Schizoid personality disorder:

40
Q

Clinical picture: social detachment and interpersonal deficits; restricted emotions; intellectual
Affects 5% of the general population and more common in males than females
Odd appearance, and will decline to engage with other people when given an opportunity

A

Schizoid personality disorder:

41
Q

Nursing interventions: focus on self-care, social skills, and improved community functioning

A

Schizoid personality disorder:

42
Q

characterized by a pervasive pattern of social and interpersonal deficits marked by acute discomfort with and reduced capacity for close relationships as well as by cognitive or perceptual distortions and behavioral eccentricities

A

Schizotypal personality disorder:

43
Q

Clinical picture:
social and interpersonal deficits, odd appearance, inability to respond to normal social cues, behavioral eccentricities

A

Schizotypal personality disorder:

44
Q

Nursing interventions:
Focus is for clients to develop self-care and social skills and improved functioning in the community
Self-care, social skills, community functioning

A

Schizotypal personality disorder:

45
Q

Odd appearance that causes others to notice them; clothes don’t fit, don’t match, and may be dirty; vague speech; anxiety around other people; remain in parents home well into adulthood

A

Schizotypal personality disorder:

46
Q

Is characterized by a pervasive pattern of disregard for and violation of the rights of others, and by the central characteristics of deceit and manipulation

A

antisocial personality disorder

47
Q 
Assessment:
Deceit/manipulation
False emotions; no empathy
Narrowed view of world
Poor judgment; no insight
Egocentric, but actually self-shallow and empty
Relationships as serving own needs
A

antisocial personality disorder

48
Q

is characterized by a pervasive pattern of unstable interpersonal relationships, self-image, and affect as well as marked impulsivity

A

borderline personality disorder

49
Q

Unstable interpersonal relationships, self-image, and affect; marked impulsivity
Wide range of behavior, appearance
Dysphoric mood
Polarized extreme thinking (splitting); dissociation
Threats of self-harm
Clients then to use transitional objects
Social isolation

A

borderline personality disorder

50
Q

Clinical picture: excessive emotionality and attention seeking; insincerity; center of attention; exaggeration of relationships

A

Histrionic personality disorder

51
Q

Nursing interventions: feedback about social interactions; social skills training through role-playing; exploration of strengths, assets
****It may also help to discuss social situations to explore clients perception of others reactions and behavior. Teaching social skills and role-playing those skills in a safe, nonthreatening environment can help clients to gain confidence in their ability to interact socially.

A

Histrionic personality disorder

52
Q

Clinical picture: grandiosity; need for admiration; lack of empathy; arrogant or haughty attitude; superior view; fragile, vulnerable self-esteem; ambitious

A

Narcissistic personality disorder

53
Q

Nursing interventions: self-awareness skills to avoid anger and frustration; matter-of-fact approach; limit setting

A

Narcissistic personality disorder

54
Q

50-75%of people with this are men; lack ability to empathize or sympathize with other; belittle or discredit the feelings of others

A

Narcissistic personality disorder

55
Q

Clinical picture:
social discomfort; low self-esteem; hypersensitivity to negative evaluation
These clients are reluctant to do anything they perceived as risky, which for them is almost everything

A

Avoidant personality disorder

56
Q

Nursing interventions: self-affirmations; positive self-talk; support and reassurance; reframing/decatastrophizing; social skills training

A

Avoidant personality disorder

57
Q

Clinical picture:
need to be taken care of; submissive; clinging
Have tremendous difficulty making decisions
Clients perceive themselves as unable to function outside of a relationship with someone who can tell them what to do

A

Dependent personality disorder

58
Q

Nursing interventions:
Clients may need assistance in daily functioning
Expression of feelings; autonomy/self-reliance; cognitive restructuring; problem solving

A

Dependent personality disorder

59
Q

Clinical picture:
The demeanor of these clients is formal and serious and they answer questions with precision and much detail
perfectionism; formal, serious; orderliness a priority; problems with decision making, judgments; low self-esteem; harsh self-evaluations

A

Obsessive personality disorder

60
Q

Nursing interventions:
Helping clients to accept or to tolerate less-than-perfect work or decisions made on time may alleviate some difficulties at work or home
different perspective view; cognitive restructuring; risk taking

A

Obsessive personality disorder

61
Q

Clinical picture:
It occurs more often in people with relatives who have major depressive disorders
pervasive depressive cognitions and behaviors (less severe than major depression); pessimistic, negative thinking; low self-esteem

A

Depressive personality behavior

62
Q

Nursing interventions:
safety; involvement in activities; factual feedback
Often seek treatment for their distress

A

Depressive personality behavior

63
Q

Clinical picture:
They may appear cooperative, even ingratiating or sullen and withdrawn, depending on the circumstances
Their mood may fluctuate rapidly and erratically
Negative attitude, passive resistance to demands for adequate social and occupational performance; blaming of others

A

Passive-aggressive personality behavior

64
Q

Nursing interventions:

Identification and expression of feelings

A

Passive-aggressive personality behavior

65
Q

Elders with personality disorders are at increased risk for?

A

depression, suicide, and dementia

66
Q

How are personality disorders organized?

A

Cluster A,B,C

67
Q

What are the cluster A personality disorders?

A

Paranoid personality disorder
Schizoid personality disorder
Schizotypal personality disorder

68
Q

What are the cluster B personality disorders?

A

Antisocial personality disorder
Borderline personality disorder
Histrionic personality disorder
Narcissistic personality disorder

69
Q

What are the cluster C personality disorders?

A

Avoidant personality disorder
Dependent personality disorder
Obsessive personality disorder

70
Q

medication for affective aggression

A

Lithium
Anticonvulsants
Low-dose antipsychotics

71
Q

medication for predatory (hostility/cruelty)

A

Antipsychotics

Lithium

72
Q

medication for emotional lability

A

Lithium
Carbamazepine (Tegretol)
Antipsychotics

73
Q

medication for emotional detachment

A

SSRIs

Atypical antipsychotics

74
Q

showing little or a slow-to-respond facial expression; few observable facial expressions

A

blunt affect

75
Q

displaying a full range of emotional expressions

A

broad affect

76
Q

showing no facial expression

A

flat affect

77
Q

false sensory perceptions or perceptual experiences that do not really exis

A

hallucinations

78
Q

displaying a facial expression that is incongruent with mood or situation; often silly or giddy regardless of circumstance

A

Inappropriate affect

79
Q

rapidly changing or fluctuating, such as someone’s mood or emotions

A

labile

80
Q

disorganized thinking that jumps from one idea to another with little or no evident relation between the thoughts

A

loose assoications

81
Q

invented words that have meaning only for the client

A

neologisms

82
Q

displaying one type of emotional expression, usually serious or somber

A

restricted affect

83
Q

wandering off the topic and never providing the information requested

A

tangential thinking

84
Q

What are the cluster A personality disorders?

A

paranoid, schizoid, Schizotypal

85
Q

What are the cluster B personality disorders?

A

antisocial, borderline, histrionic, narcissistic

86
Q

What are the cluster C personality disorders?

A

avoidant, dependent, obsessive

Mental health exam 2 (5 decks)

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