Exam 11-15

Obsessions

Recurrent, persistent, intrusive, and unwanted thoughts, images, or impulses that cause anxiety.

Compulsions

Ritualistic or repetitive behaviors or mental acts, such as checking, counting, or washing, carried out to eliminate obsessions or neutralize anxiety.

Dermatillomania

Also known as excoriation or skin-picking; a self-soothing behavior commonly involving the face, fingers, hands, arms, and legs.

Trichotillomania

Chronic, repetitive hair pulling; a self-soothing behavior that typically begins in childhood and can progress into adulthood.

Body Dysmorphia Disorder (BDD)

Preoccupation with an imagined or slight defect in physical appearance that interferes with daily functioning, often overlapping with anxiety and depression.

Hoarding

A disorder characterized by excessive acquisition of animals or useless things and cluttered living spaces, commonly starting between ages 20 and 30.

Onychophagia

Chronic nail biting, which is classified as a self-soothing behavior.

Kleptomania

Compulsive stealing characterized as reward-seeking behavior, where the primary reward is the thrill of not getting caught.

Oniomania

Compulsive buying where the reward is the acquisition of the item rather than its use; it affects 80% females in their 20s and college students.

Body Identity Integrity Disorder (BIID)

Also known as amputee identity disorder or apotemnophilia; a condition where individuals feel 'overcomplete' and desire the amputation of a limb.

Cognitive Models of OCD

Derived from Beck’s approach, these models focus on the belief that thoughts are overly important, perfectionism, intolerance of uncertainty, and inflated personal responsibility.

First-line OCD Medications

SSRI antidepressants including fluvoxamine (Luvox) and sertraline (Zoloft).

Second-line OCD Medication

The antidepressant venlafaxine (Effexor).

Exposure Therapy

A behavioral therapy technique that assists the client in deliberately confronting situations and stimuli they usually avoid.

Response Therapy

A behavioral therapy technique focused on delaying or avoiding the performance of rituals.

Somatic Therapies

Treatments for treatment-resistant OCD that involve targeting neurosurgical lesions in the corticostriatal-thalamic-cortical tracts of the brain.

Anafranil

The brand name for clomipramine, an antidepressant helpful in treating trichotillomania.

General Adaptation Syndrome

A three-stage physiological reaction to stress identified by Hans Selye, consisting of the alarm reaction, resistance stage, and exhaustion stage.

Alarm Reaction Stage

The first stage of stress response where the hypothalamus sends messages to glands and organs, the adrenal gland releases adrenaline, and the liver converts glycogen to glucose for defense fuel.

Resistance Stage

The second stage of stress response where the digestive system reduces function, blood is shunted to defense areas, and lung and heart activity increases.

Exhaustion Stage

The final stage of stress response characterized by the depletion of body stores, continual arousal of physiological responses, and little reserve capacity.

Sympathetic nerve fibers

Part of the autonomic nervous system that charges up vital signs at any hint of danger by prompting the adrenal glands to release adrenaline.

Parasympathetic nerve fibers

Part of the autonomic nervous system that reverses the stress process and returns the body to normal conditions.

Mild anxiety

An anxiety level characterized by a wide perceptual field, sharpened senses, increased motivation, and effective problem-solving.

Moderate anxiety

An anxiety level where the perceptual field narrows to the immediate task and the individual is selectively attentive and may require short, simple sentences to follow information.

Severe anxiety

An anxiety level where the perceptual field is reduced to one detail or scattered details, tasks cannot be completed, and the individual feels awe, dread, or horror.

Panic anxiety

An anxiety level involving distorted perceptions, loss of rational thought, and a total focus on the self; may include delusions, hallucinations, or a flight, fight, or freeze response.

Heritability

The proportion of any disorder attributed to genetic factors, where levels greater than $0.6$ indicate dominant genetic influence and levels less than $0.3$ indicate negligible genetic influence.

Gamma-aminobutyric acid (GABA)

The inhibitory neurotransmitter that reduces cell excitability and is dysfunctional in anxiety disorders.

Defense mechanisms

Cognitive distortions used unconsciously to maintain control and reduce awareness of anxiety, as described by Freud.

Interpersonal Theory (Sullivan)

The view that anxiety is generated from problems in interpersonal relationships and can be communicated from caregivers to children through inadequate nurturing.

Panic disorder

An anxiety disorder involving discrete episodes of panic attacks lasting $15$ to $30\,\text{minutes}$ characterized by rapid, intense, escalating anxiety and physical symptoms like palpitations and chest pain.

Phobia

An illogical, intense, and persistent fear of a specific object or social situation that causes extreme distress and interferes with normal functioning.

Anticipatory anxiety

The anxiety that develops when thinking about encountering a phobic object or situation, often leading to avoidance behavior.

Systematic desensitization

A behavioral therapy technique involving progressive exposure to a phobic object in a safe setting to reinforce reduced anxiety.

Flooding

A method of rapid desensitization where a client is confronted with a phobic object until anxiety decreases; must be conducted by a trained psychotherapist.

Generalized Anxiety Disorder (GAD)

A disorder characterized by excessive worry and anxiety for at least $50\%$ of the time over a period of $6\,\text{months}$, causing muscle tension, irritability, and sleep alterations.

Social anxiety disorder (Social phobia)

Severe anxiety in social or performance situations due to the fear of being judged, looking socially inept, or doing something embarrassing.

Benzodiazepines

A class of medications including Diazepam (Valium) and Alprazolam (Xanax) used for anxiety that carry side effects of dizziness, sedation, and high potential for abuse.

Buspirone (BuSpar)

A nonbenzodiazepine anxiolytic used to treat GAD and social phobia that should be taken with food and reported if persistent restlessness occurs.

Cognitive restructuring

Techniques used to help clients reframe and manage thoughts to reduce overall anxiety and regain self-control during panic attacks.

Adjustment Disorder

A condition characterized by more than expected difficulty in coping with a stressful event (often financial, relationship, or work-related), where symptoms develop within $1$ month and last no more than $6$ months.

Reactive Attachment Disorder (RAD)

A disorder occurring before age $5$ in response to the trauma of child abuse or neglect (grossly pathogenic care), characterized by minimal social and emotional responses to others and a lack of positive affect.

Posttraumatic Stress Disorder (PTSD)

A pattern of behavior following a major trauma, beginning at least $3$ months after the event, featuring symptoms like reexperiencing events, hyperarousal, insomnia, and feelings of guilt or shame.

Exposure Therapy

A specialized therapy program common in treating PTSD that specifically combats avoidance behavior.

Adaptive Disclosure

A specialized version of Cognitive Behavioral Therapy (CBT) developed by the military for active-duty military personnel with PTSD.

Cognitive Processing Therapy

A therapy used specifically for victims of sexual assault and those with combat-related PTSD.

Dissociation

A defense mechanism that protects the emotional self from traumatic events by allowing the mind to forget or remove itself from painful memories.

Dissociative Amnesia

A disorder involving the inability to remember important personal information, usually related to traumatic or stressful events.

Fugue Experience

A manifestation of dissociative amnesia where an individual suddenly moves to a new location with no memory of past events, often assuming a new identity.

Dissociative Identity Disorder (DID)

A disorder characterized by the presence of two or more distinct identities or personality states that recurrently control the individual's behavior, accompanied by memory gaps.

Depersonalization

A persistent feeling of being detached from one's own mental processes or body, while maintaining a sense of reality.

Derealization

A sensation of being in a dream-like state where the environment seems foggy or unreal, though the client is not psychotic.

Reassociation

The focus of therapy for dissociative disorders which aims to put consciousness back together and improve functional abilities.

Acute Stress Disorder

A condition that occurs from $2$ days to $4$ weeks following an intense traumatic event; it can sometimes be a precursor to PTSD.

Grounding Techniques

Methods used by nurses to help clients minimize dissociative episodes or flashbacks by providing reality orientation.

Hyperarousal

A symptom of PTSD defined by being "super alert," watchful, on guard, jumpy, or easily startled.

Intimate Partner Violence (IPV)

Mistreatment or abuse in an emotionally intimate relationship that can be emotional, psychological, physical, sexual, or a combination.

Honeymoon period

A stage in the cycle of violence characterized by regret, apologies, and romantic behavior that initially lasts weeks or months but becomes less frequent over time.

Tension-building phase

A phase in the cycle of violence involving arguments and complaints that precedes repeating violent episodes.

Intergenerational Transmission Process

The perpetuation of violence patterns through generations via role modeling and social learning, where children witness parental violence and learn it as conflict resolution.

Social Isolation

A behavior exhibited by violent families where members keep to themselves, do not invite others into the home, and do not disclose abuse due to threats of greater harm.

Rohypnol

A specific drug mentioned as a date rape drug that has seen a rise in use during acquaintance and date rape incidents.

Child abuse

The intentional injury of a child including physical injuries, neglect, failure to provide care, abandonment, sexual assault, or overt torture.

Contrecoup injuries

Brain injuries associated with shaken baby syndrome that may be described by parents with histories inconsistent with the severity of the injury.

Mandatory reporting

Legal requirement in all $50$ states for nurses to report suspected child abuse, allowing the reporting person to remain anonymous.

Elder abuse

Maltreatment of older adults (estimated $1$ in $10$ people over $60$) by family members or caregivers, including physical, sexual, psychological, and financial exploitation.

Self-neglect

An indicator of elder abuse where the older adult is unable to manage personal finances, personal care, or housework, often failing to keep medical appointments.

Financial exploitation

A form of elder abuse characterized by unpaid bills, unusual bank activity, forged signatures on checks, or unauthorized changes in a will or power of attorney.

Rape

Nonconsensual sexual intercourse overcome by force, fear, drugs, or intoxicants.

Sexual assault

A crime of violence and humiliation through sexual means, including sodomy and forced oral sex, often occurring when a victim is unable to consent due to age or mental deficiency.

Sexual assault nurse examiners

Specially trained health care professionals who conduct physical examinations, describe the incident based on patient reports, and collect physical evidence using rape kits.

Stalking

Persistent attempts to impose unwanted communication or contact, including cyberstalking via social media and tracking apps.

Bullying

A form of community violence in schools involving verbal aggression, physical acts, shunning, or cyberbullying, experienced by nearly one third of $U.S.$ students.

Ostracism

A consequence of bullying that involves shunning or ignoring a student, which creates threats to the individual's belonging, self-esteem, and control.

Hazing

Common practices in high schools and colleges involving alcohol consumption, humiliation, isolation, or sleep deprivation to gain status in athletic teams or fraternities.

Anger

A normal and healthy reaction that occurs when situations are unfair or unjust, personal rights are not respected, or realistic expectations are not met.

Hostility

Verbal aggression that aims to intimidate or cause emotional harm.

Physical Aggression

Behavior that aims to harm, punish, or force compliance.

Triggering Phase

The phase of an aggressive incident where an event initiates an aggressive response.

Escalation Phase

The phase of an aggressive incident characterized by an increasing loss of control.

Crisis Phase

The phase of an aggressive incident involving a total loss of emotional and physical control.

Recovery Phase

The phase of an aggressive incident where the client is regaining control.

Postcrisis Phase

The final phase of an aggressive incident involving reconciliation and return to normal functioning.

Anger Attacks in Depression

Sudden intense spells of anger or rage, typically followed by remorse, occurring when a person feels emotionally trapped.

Intermittent Explosive Disorder (IED)

A rare psychiatric diagnosis involving discrete episodes of aggressive impulses and serious assaults grossly disproportionate to any provocation.

Acting Out

An immature defense mechanism involving dealing with emotional conflicts or stressors through actions rather than feelings.

Serotonin

A neurotransmitter with an inhibitory role; low levels are associated with increased aggressive behavior.

Hwa-Byung

A cultural syndrome seen in Korea, predominantly in females, characterized by physical and emotional symptoms of anger.

Bouffe délirante

A cultural syndrome observed in West Africa and Haiti involving sudden outbursts of agitated and aggressive behavior.

Amok

A dissociative episode seen in males characterized by violent, aggressive behavior following a perceived insult.

Lithium

A medication used to treat comorbid aggression in bipolar disorder, conduct disorders, and intellectual developmental disorder.

Carbamazepine (Tegretol)

An anticonvulsant used to manage aggression in dementia, psychosis, and personality disorders.

Benztropine (Cogentin)

A medication used to treat extrapyramidal side effects associated with antipsychotic use.

Workplace Bullying

Also known as lateral or horizontal violence, this includes verbal abuse, threatening, intimidating, or humiliating behaviors and work interference.

Show of Force

A technique used during the escalation phase where additional staff members are present to demonstrate that the staff will take control if necessary.