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Unit 5 MH

Terms in this set (50)

Psychoanalytic Theory
Freuds theory of personality structure, levels of awareness, anxiety, the role of defense mechanisms, and the stages of psychosexual development.

Believed that mental disorders resulted from unresolved issues that originated in childhood.
Levels of Awareness
Conscious, Preconscious, Unconscious
Conscious:
Tip of iceberg. Contains all of the material a person is aware of at anytime including perceptions, memories, thoughts, fantasies, and feelings
Preconscious:
Just below the surface of awareness.
Contains material that can be retrieved rather easily through conscious effort
Unconscious:
All repressed memories, passions, and unacceptable urges lying deep below the surface.
Memories associated with trauma because they are too painful to deal with.
Personality Structure
-Id, Ego, Superego
-all work together
-if Id is too powerful, the person will lack control over impulses
-if superego is too powerful, the person may be self critical and suffer from feelings of inferiority
Id:
-At birth
-Source of all drives, instincts, reflexes, and needs
-Wants to return to a more comfortable level
-lacks ability to problem solve and is illogical
-Ex: hungry screaming baby
Ego:
-Problem solver & reality tester
-Attempts to navigate the outside world
-Factors in reality to implement a plan to decrease tension
-Ex: a hungry man plans where he is going to get his meal
Superego:
-developes between ages 3 and 5
-Moral component of personality
-When behavior falls short of ideal guilt is felt
-when behavior is ideal pride is felt
Defense Mechanisms and Anxiety
-All except suppression operate on an unconscious level
-they deny, falsify, or distort reality to make it less threatening
Psychosexual Stages of Development
-Oral
-Anal
-Phallic
-Latency
-Genital
Oral stage
-0 to 1 year
-sucking, biting, chewing
-development of trust in the environment, with the realization that needs can be met
Anal stage
-1 to 3 year
-Expulsion and retention of feces
-control over impulses
-obsessive compulsive disorder
Phallic Stage
-3 to 6 year
-Genitals masturbation
-identification with parent of the same sex
-Narcissistic
Latency Stage
-6 to 12 year
-the development of skills needed to cope with the environment
-developing social skills
Genital Stage
-12 and beyond
-Genitals (Sexual intercourse)
-The ability to be creative and find pleasure in love and work
Classical Psychoanalysis
-Seldom used today
-Intrapsychic conflict is no longer seen to be the cause of mental illness
-valid tools are transference and countertransference
Psychodynamic Therapy
-therapy deriving from the psychoanalytic theory however therapists has increased involvement and interacts with the patient more freely
-therapy oriented towards here and now
-tends to last longer and may extend for more than 20 sessions
-Best candidates are the "WORRIED WELL", meaning they are intelligent and well motivated for change
-rapid back and fourth between therapist and patient
Interpersonal Theory
-Sullivan
-he viewed loneliness as the most painful human condition
-emphasized that early relationships with the primary parenting figure or significant other are crucial for personality development
-The purpose of all behavior is to get needs met through interpersonal interactions and to reduce/avoid anxiety
-Security operations: describe measures the individual employs to reduce anxiety and enhance security
Interpersonal Therapy
-Effective short term therapy
-Goal is to reduce or eliminate psychiatric symptoms (particularly depression) by improving interpersonal functioning and satisfaction with social relationships
Three problems that respond well to interpersonal therapy:
1. Grief and Loss
2. Interpersonal disputes (conflict with significant others)
3. Role transition (retirement)
Peplau's Theory of Interpersonal Relationships
-Shift from what nurses do TO the patients to what nurses do WITH the patients
-Concerned with the processes by which the nurse helps patients make positive changes in their health care status and well being
-Nurses are both participants and observers in therapeutic conversations (mutuality, respect, empathy, and unconditional acceptance)
-levels of anxiety (mild, moderate, severe, panic)
-Interventions to lower anxiety with the aim of improving patients ability to think and function at more satisfactory levels
Classical Conditioning
-Pavlov
-neutral stimulus (bell) repeatedly paired with another stimulus (food)
-Boy becoming ill after eating spoiled coleslaw, when smelling coleslaw later in life he feels nauseated
-responses are involuntary (not under conscious personal control)
Behavioral Therory
-Watson
-Personality traits and responses (adaptive or maladaptive) were socially learned through classical conditioning
-controlling the environment could mold behavior and anyone could be trained to be anything
-Little albert being scared of white furry things
Operant Conditioning
-Skinner
-Rewards and punishment for voluntary behavior
-reinforcement makes behavior more frequent
-Modifying or replacing behaviors
-Positive and negative reinforcement
-Extinction: the absence of reinforcement (Teacher ignoring a joke told in class)
Behavioral Therapy
-works best in treating people with phobias, alcoholism, schizophrenia, and many other conditions
Modeling
-therapist provides a role model for specific identified behaviors
-patient learns through imitation
-Ex: person scared of snakes watches a person interact with a snake
Operant Conditioning (behavioral therapy)
-has seen to improve behaviors of mute, autistic, and developmentally disabled children.
-positive reinforcements increase desired behaviors
Systematic Desensitizaion
1. The patients fear is broken down into components
2. The patient is exposed to the fear little by little
3. The patient designs a hierarchy of fears and uses relaxation techniques to reach state of relaxation as they progress through the list
4. The patient practices techniques everyday
Aversion Therapy
-Treats behaviors such as alcoholism, paraphilic disorders, shoplifting, violent and aggressive behaviors, and self mutilation.
-Pairing of a negative stimulus with a specific target behavior
-Used when other less drastic measures fail
Biofeedback
-controls body's physical response to stress and anxiety
-Monitor HR, BP, brain waves, muscle activities
Cognitive Theory and Therapies
-Dynamic interplay between individuals and the environment
-thoughts come before feelings and actions
-thoughts about the world and our place in it are based on our own unique perspectives, which may or may not be based on reality
Rational Emotive Behavior Therapy
-Ellis
-remove core irrational beliefs by helping recognize thoughts that are not accurate, sensible, or useful
-negative thinking is an ABC process
-A: activating
-B: beliefs
-C: emotional consequence
-it often boiled down to if the glass is half empty or full
-if our beliefs are negative and self depreciating we are more susceptible to depression and anxiety
Cognitive Behavioral Therapy
-Beck
-test distorted beliefs and change way of thinking
-cognitions are based on attitudes or assumptions are developed from previous experience
-Schemas: the only person I can trust is myself
Maslows Heirarchy of Needs
-humans are motivated by unmet needs
-humans are active participants in life striving for self-actualization
-when lower needs are met, higher needs are able to emerge
-Physiological needs: food, oxygen, water, sleep, sex
-Safety needs: security, protection, freedom from fear
-Belonging and love needs: intimate relationships, love, affection, belonging
-Esteem: high self-regard
-Self-actualization: what people are capable of becoming
Human Motivation
-emphasis on human potential and the patients strengths is key to successful nurse patient relationships
-Prioritize nursing actions in the nurse patient relationship
Biological Model
-consider influences that play a role in the development and treatment of mental disorders (social, environmental, cultural, economic)
-Nursing interventions focus on: qualities of a therapeutic relationship, understanding the patients perspective, and communicating to facilitate recovery
Psychopharmacology
-Chlorpromazine (Thorazine): a powerful antipsychotic that controls psychosis, mania, depression and anxiety
Electroconvulsive therapy (ECT)
-experience retrograde amnesia
-treat major depressive disorder, refractory psychosis
Cognitive Development
Sensorimotor, Preoperational, Concrete operational, and formal operational stages
Sensorimotor stage
-Birth to 2 years
-basic reflexes and culminates with purposeful movement, spatial abilities, and hand eye coordination
-basic understanding of the world
Preoperational Stage
-2 to 7 years
-think in a concrete fashion
-tendency to expect others to view the world as they do
-unable to converse mass, volume, or number
Concrete Operational Stage
-7 to 11 years
-logical thought and abstract problem solving
-see situations form another point of view
Foraml Operational Stage
-11 to adult
-basic abilities to think abstractly and problem solve
-mirror those of an adult
Theory of Psychosocial Development
-Erickson
-Infancy (0 to 1.5): trust vs mistrust
-Early Childhood (1.5 to 3): autonomy vs shame and doubt
-Preschool (3 to 6): Initiative vs guilt
-School age (6 to 12): Industry vs inferiority (developing social skills)
-Adolescent (12 to 20): identity vs role confusion
-Early adulthood (20 to 35): intimacy vs isolation
-Middle adulthood (35 to 65): generativity vs self-absorption (fulfilling life goals)
-Later years (65 to death): integrity vs despair (looking back at life)
Theory of Object Relations
-Mahler
-Past relationships influence a persons sense of self as well as the nature and quality of relationships in the present
-object is a significant person
Stages of Moral Development
-Kohlberg
-Preconventional Level, Conventional Level, and postconventional level
Preconventional Level
Stage 1: Obedience and Punishment
Stage 2: individualism and exchange
Conventional Level
Stage 3: good interpersonal relationships
Stage 4: Maintaining social order
Postconventional Level
Stage 5: social contracts and individual rights
Stage 6: Universal ethical principals
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