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PMHN EXAM 2
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Gravity
Terms in this set (61)
a sudden event in one's life during which usual coping mechanism cannot resolve the problem and homeostasis is disturbed
a crisis
what 3 factors determine whether an individual is experiencing a crisis in response to a stressful situation?
1. individual's perception of the event
2. availability of situational supports
3. availability of adequate coping mechanisms
dispositional crisis, and example
an acute response to an external situational stressor (house fire, call 911 immediately)
crisis of anticipated life transitions
normal life cycle transition that may be anticipated but over which the individual may feel a lack of control
crisis resulting from traumatic stress
precipitated by an unexpected, external stressor over which the individual has little or no control and from which he or she feels emotionally overwhelmed and defeated
maturational/developmental crisis
occurs in response to a situation that triggers emotion related to unresolved conflicts in one's life
crisis reflecting psychopathology
an emotional crisis in which preexisting psychopathology has been instrumental in precipitating the crisis or in which psychopathology significantly impairs or complicates adaptive resolution
psychiatric emergency
a crisis situation in which general functioning has been severely impaired and the individual rendered incompetent or unable to assume personal responsibility
steps to take in OD crisis
1. assess pt for responsiveness
2. call 911
3. perform cpr
4. naloxone IM or nasally
5. arrange for follow up tx
what is naloxone given for?
overdose
what is a major difference between anger and aggression?
intent to inflict harm/destruction
most widely recognized risk factor for violence?
previous acts of violence
3 factors important in predicting aggression
1. past history of violence
2. client diagnosis
3. current behaviors
prodromal syndrom
certain current behaviors predictive of impending violence
dx associated with violence
- schizophrenia
- major depression
- bipolar
- substance use
- antisocial
- neurocognitive disorders
- borderline/intermittent personality disorders
Paraphilias
Urges or activities that involve unusual objections, activities, or situations and cause clinically significant distress or impairment
paraphilia gender dominance
male
Exhibitionistic disorder
Exposing oneself
Frotteuristic disorder
Touching and rubbing against a nonconsenting person
Sexual masochism disorder
Only aroused by experiencing pain, humiliating
Sexual sadism disorder
Only aroused by inflicting pain or humiliation
transvestic disorder
Cross dressing
Bestiality
Attraction to animals
influences on personality development
temperament, heredity, experiential learning, and social interaction
"i want"
the id
"i am"
the ego
"i should"
the superego
personality disorder
an enduring pattern of inner experience and behavior that deviates from cultural norms, and is pervasive and inflexible, and causes distress in important areas of functioning
what is the typical onset of bipolar disorder?
adolescence or early adulthood
cluster A behavior is?
odd and eccentric
cluster b behavior is?
erratic, dramatic, and emotional
cluster c behavior is?
anxious and fearful
is anxiety the same as stress?
no, anxiety is a necessary force for survival
when does anxiety become too much?
when it is out of proportion to the situation causing it and begins to interfere with any area of functioning
Agoraphobia
Fear of being in places or situations from which escape might be difficult or in which help might not be available in the event of panic-like symptoms or other incapacitating symptoms.
what has a major effect on a person's perception of the world
mood
the emotional reaction associated with an experience
affect
what disorder is characterized by mood swings from profound depression to extreme euphoria/mania with intervening periods of normalcy?
bipolar
diagnostic criteria for bipolar?
includes a history of one or more manic episodes
average of onset for bipolar
early 20s
Bipolar I disorder
full syndrome of manic or mixed symptoms and may have experienced episodes of depression
Bipolar II disordr
bouts of major depression with episodic occurence of hypomania - has never met criteria for full manic episode
cyclothymic disorder
chronic mood disturbance for atleast 2 years but with insufficient criteria for bipolar I or II disorder
bipolar disorder is viewed as a disease of?
the brain - lesions, enlarged ventricles
what is the FIND method?
method used to help in the diagnosis of bipolar disorder in children
FIND acronym
Frequency: most days in a week
Intensity: severe enough to cause extreme disturbance
Number: 3-4 times/day
Duration: 4+ hours/day
most common comorbid condition to bipolar?
ADHD
when should ADHD medications be administered in bipolar children?
only after bipolar symptoms are controlled as ADHD agents could exacerbate mania
family interventions for bipolar children
- education about disorder
- communication training
- problem-solving skills training
does acute mania require hospitalization?
usually
does acute mania cause impairement in functioning?
marked
does hypomania cause impairment in functioning?
no
hypomania characteristics
- cheerful mood
- irritable if they don't get their way
- rapid flow of ideas
- heightened perception of self worth
- easily distracted
acute mania characteristics
- continues "high"/elation
- flight of ideas
- accelerated, pressured speech
- hallucinations and delusions
- excessive motor activity
- social and sexual inhibition
- little need for sleep
delirious mania characteristics
- labile mood
- panic anxiety
- clouding of consciousness/disorientation
- frenzied motor activity
- exhaustion leading to death without intervention
do the seasons often affect bipolar?
yes, bipolar disorder is cyclic in nature
lithium therapeutic range
0.6-1.5
what should include a lot of in the diet when taking lithium?
sodium and fluids (6-8 glasses/day)
how often should you have serum lithium levels checked?
every 1 to 2 months
criteria for major depressive disorder
- depressed mood
- loss of interest
- symptoms present for at least 2 weeks
- no history of manic behavior
- can't be attributed to substance use or other medical conditions
what is the mechanism of action of ECT?
thought to increase levels of serotonin, norepinephrine, and dopamine
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