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occupational therapy mental health content questions

Sign/Symptoms of Mental Health Disorders

Consciousness, Attention, Emotion, Motor, Thinking, Speech, Perception, Memory

Consciousness

State of Awareness

Disturbances in Consciousness

Disorientation, Delirium, Confusion, Sundowning

Disorientation

Disturbance of person, place, time or situation

Delirium

Disoriented reaction w/ restlessness and confusion

Confusion

Inappropriate reactions to environmental stimuli

Attention

ability to remain focused/concentrate

Disturbances in Attention

Distractibility, Selective Inattention, Hyperviligence, Trance

Distractibility

Inability to concentrate due to inability to block out irrelevant stimuli

Selective Inattention

Blocking out what creates anxiety

Hyperviligence

Excessive alertness that guards against danger

Trance

Sleeplike state, followed by amnesia

Emotion

a feeling state associated w/ affect and mood; psychological and physical components

Affect

Observable component of emotion

Disturbances in Affect/Emotion

Appropriate, Inappropriate, Blunt, Restricted, Flat, Labile

Appropriate Affect

Consistent with idea, thought and speech

Inappropriate Affect

Inconsistent with idea, thought and speech

Blunt Affect

Severe lack of affect

Restricted Affect

Reduced affect (less than blunt)

Flat Affect

Absence of affect

Labile Affect

Rapid changes in affect

Mood

Pervasive and sustained emotion, manifested by thoughts and actions

Disturbances in Mood

Anxiety, Free Floating Anxiety, Fear

Anxiety

Apprehension/worry with anticipation of future danger

Free Floating Anxiety

Pervasive anxiety with no specific focus

Fear

Anxiety associated with real danger

Physiological disturbances with Mood...

...are often autonomic

Motor Behavior

Behavior/motor expression of impulses, drives, wishes, motivation, cravings

Disturbances in Motor Behavior

Echopraxia, Catatonia, Sterotypy, Psychomotor agitation, Hyperactivity, Hypoactivity, Aggression, Acting out, Akathisia, Ataxia

Echopraxia

Meaningless imitation of another persons movements

Catatonia

Immobility or rigidity

Stereotypy

Repetition of fixed patterns of movement/speech (ex. echolalia)

Psychomotor agitation

Excessive activity (could be cognitive); usually none productive and in response to inner tension

Hyperactivity

Restless, aggressive or destructive activity

Hypoactivity

Decreased or slow motor/cognitive activity

Akathisia

State of restlessness with an urgent need for movement; often medication side effect

Ataxia

Irregularity/failure of muscle coordination upon movement

Thinking

Goal directed reasoned flow of ideas/associations; when thinking follows a logical sequence it is considered normal

Disturbances in Thinking (Form)

Circumstantiality, Tangentiality, Perseveration, Flight of Ideas, Thought Blocking

Circumstantiality

Speech that is delayed in reaching the point; contains excessive/irrelevant details

Tangentiality

Abrupt change of focus to loosely associated topic

Perseveration

Persistent focus on a previous topic/behavior after a new topic/behavior is introduced

Flight of Ideas

Rapid shift in thoughts from one idea to another

Thought Blocking

Interruption of a thought process before it is carried out to completion

Disturbances in Thinking (Content)

Delusions, Compulsions, Obsessions, Phobias, Hypochondria, Poverty of Content

Delusions

False beliefs about external reality without appropriate stimulus

Compulsions

Need to act out specific impulses to relieve associated anxiety

Obsessions

Persistent thought or feeling that cannot be eliminated by logical thought

Speech

Expression of ideas, thoughts, feelings through language

Disturbances in Speech

Pressured speech, Poverty of speech, Nonspontaneous speech, Stuttering, Perseveration

Pressured Speech

Rapid/increased in amount

Poverty of Speech

Limited in amount/content

Nonspontaneous Speech

Responses given only when the person is spoken to directly

Stuttering

Repetition/prolongation of sounds/syllables

Perseveration

Continued repetition of word/phrase

Disturbances in Language Output

Expressive aphasia, Receptive aphasia, Nominal aphasia, Global aphasia

Expressive Aphasia

Cannot say what the individual knows they want to say

Receptive Aphasia

Cannot comprehend what is said

Nominal Aphasia

Inability to name objects

Global Aphasia

Involves all forms of aphasia

Perception

Process of interpreting sensory information received from the environment

Disturbances in Perception

Hallucinations, Illusions

Hallucinations

False sensory perceptions; not in response to an external stimuli

Illusions

Misperceptions/misinterpretations of real sensory events

Disturbances Associated with a Cognitive Disorder

Agnosia, Astereognosis, Visual Agnosia, Apraxia, Adiadochokinesia

Agnosia

Inability to understand/interpret significance of sensory input

Astereognosis

Inability to identify objects through touch

Visual Agnosia

Inability to recognize people and objects

Apraxia

Inability to carry out specific motor task in the absence of sensory or motor impairment

Adiadochokinesia

Inability to perform rapidly alternating movements

Disturbances Associated with Conversion/Dissociative Phenomena

In response to repressed material; involves physical symptoms not under voluntary control

Depersonalization, Derealization, Fugue, Dissociative Identity Disorder, Dissociation

Depersonalization

Subjective sense of being unreal or inanimate

Derealization

Subjective sense that the environment is unreal

Fugue

Serious depersonalization, involves travel/relocation, person takes on a new identity with amnesia of old identity

Dissociative Identity Disorder

Involves the appearance that the person has developed 2 or more distinct personalities

Dissociation

Separation of a group of mental or behavioral processes from the rest of the person's psychic activity; may involve separating an idea from its emotional tone

Memory

Ability to store/retrieve information from the past

Levels of Memory

Immediate: ability to recall material within sec or min
Recent: ability to recall material from the past few days
Remote: ability to recall events of distant past

Disturbances of Memory

Amnesia: inability to recall past experiences or personal identity; organic or emotional cause
Retrograde Amnesia: inability to remember events that occurred PRIOR to the event

DSM-IV-TR Axes

Axis 1: clinical disorders
Axis 2: personality disorders and MR
Axis 3: general medical conditions
Axis 4: psychosocial and environmental problems
Axis 5: global assessment of functioning

DSM-IV-TR Diagnosis

Made when criteria is met:
a) behavior is not caused by other medical conditions, substance abuse, or medication
b) symptoms cause significant distress and impairment in function
c) symptoms cannot be better accounted for by another diagnosis

Global Assessment of Function (GAF)

Considers psychological, social, and occupational functioning on a hypothetical continuum of mental health. DOES NOT include impairment in functioning due to physical/environmental limitations

Global Assessment of Function Scale

100-91 Superior
90-81 Absent, Minimal
80-71 Transient, expected reactions
70-61 Mild
60-51 Moderate
50-41 Serious
40-31 Impairment in reality testing or communication
30-21 Behavior influenced by delusion or hallucination or serious impairment in communication/judgement
20-11 Some danger to self/others
10-1 Persistent danger to self/others
0 Inadequate information

Schizophrenia + Symptoms

Delusions, Hallucinations, Disorganized Speech, Grossly Disorganized or Catatonic Behavior

Schizophrenia - Symptoms

Restricted Emotion, Decreased Thought and Speech, Lack of Motivation and Initiative, Inability to Relate to Others

Subtypes of Schizophrenia

Paranoid, Disorganized, Catatonic, Undifferentitated, Residual

Paranoid Schizophrenia

Preoccupation with 1 or more delusions of persecution or grandeur
Auditory hallucinations frequent
Exhibit fewer negative symptoms

Disorganized Schizophrenia

Distinguished by marked regression; demonstrate primitive, disinhibiting and disorganized behavior

Catatonic Schizophrenia

Severe disturbances in motor behavior involving stupor, negativism, rigidity, excitement or posturing

Undifferentiated Schizophrenia

Used for those who do not clearly fit into other categories

Residual Schizophrenia

Continued evidence of schizophrenic behavior in the absence of a complete set of diagnostic criteria

Schizopreniform Disorder

Individual meets requirements for schizophrenia with an episode that lasts for more than 1 month but less than 6 months

Schizoaffective Disorder

Uninterrupted period of illness which is characterized by either a major depressive, manic or mixed episode concurrent with symptoms that meet Criteron A for schizophrenia (+symptoms)

Delusional Disorder

Predominant symptoms are non-bizarre delusions with the absence of other Criterion A symptoms (+symptoms)

Brief Psychotic Disorder

At least 1 day, but less than 1 month of Criterion A symptoms (+symptoms) which result from severe psychological stress

Antipsychotic Medication Side Effects

Dry mouth, Blurry vision, Photosensitivity, Orthostatic Hypertension, Parkinsonism, Dsytonias, Akathisias, Tardive Dyskinesia, Cardiac symptoms

Neuroleptic Malignent Syndrome

Autonomic emergency; increase in BP, tachycardia, sweating, confusion, coma

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