intro to psych - krysiak

what is a mental disorder?

behavioral or mental pattern causing significant distress or impairment of personal functioning

T/F the diagnostic and statistical manual of mental disorders (DSM) is a treatment guideline

FALSE — used for diagnosis, assessment, and description of mental disorders

list barriers when it comes to interviewing patients

• patient paranoia

• ambivalence

• disorganization

• stigma

what is needed to obtain “collateral information”?

collateral info = speaking to family, SOs, other clinicians, medical diagnosis, lab testing, med list, verbal written records

release of information (ROI)

list interview techniques

• safe, quiet, private, non-stimulating, and comfortable area

• establish trust

• avoid leading the patient

• listen

• do not judge

• employ motivational interviewing

how do you avoid leading the patient when interviewing?

• start with open-ended questions

• transition to more specific to fill in info

what are the OARS of motivational interviewing?

• O: open ended questions

  • ensures pt does majority of talking

  • avoids leading the pt

• A: affirmations

  • build rapport

  • helps pt feel that they are being heard

• R: reflective listening

  • helps pt identify discrepancies in their thinking

• S: summary

  • reinforces commitment of pt to make a change

checkpoint

which of the following best describes the DSM-V?

a. it is a guideline that can be used for practice

b. includes doses of meds used for psych conditions

c. includes info regarding diagnosis of psych conditions

c.

list the components of a mental status examination (MSE)

• appearance

• attitude

• activity

• speech and language

• mood and affect

• thought and perceptual disturbances

• cognition

• insight and jusgment

what should we clock in terms of appearance and atittude of pt during a MSE?

• age

• dress

• grooming

• hygiene

• facial expressions

what kind of overactivity should we look for in a MSE?

• hand wringing

• restless leg movements

• picking clothing, skin, or hair

• pacing, fidgeting

what kind of underactivity should we look for in a MSE?

• rigidity

• absence of movement

• catatonia

what should we assess in terms of speech and language in a MSE?

• quantity, flow, and speed

• eye contact

• logicalness

• goal-directed manner?

• vague or poorly organized?

which of the following is when a patient stops speaking suddenly without explanation?

a. thought blocking

b. pressured speech

c. flight of ideas

a.

which of the following is when there is accelerated pace to speech pattern with an urgency seemingly inappropriate to the situation?

a. thought blocking

b. pressured speech

c. flight of ideas

b.

which of the following is when a patient changes from topic to topic abruptly?

a. thought blocking

b. pressured speech

c. flight of ideas

c.

which of the following is when a patient gets sidetracked, but returns to the point?

a. circumstantial speech

b. tangential speech

a.

which of the following is when the patient goes off-topic and never returns to the original question?

a. circumstantial speech

b. tangential speech

b.

which of the following is repetition of an original answer to subsequent questions?

a. perseveration

b. mutism

a.

which of the following is when the patient does not respond even though they are aware of the discussion?

a. perseveration

b. mutism

b.

which of the following is the current emotional tone observed by the clinician (objective)?

a. affect

b. mood

a.

which of the following is feelings reported by the patient (subjective)?

a. affect

b. mood

b.

distinguish between flat affect, excited affect, and blunted affect

flat affect: no change in expression

excited affect: very intense and often excited

blunted affect: range of emotional expression is reduced

what is rapid, often exaggerated changes in mood?

a. inappropriate or incongruent affect

b. labile affect

b.

what is inappropriate affect to the patient’s mood or content of ideas or speech?

a. inappropriate or incongruent affect

b. labile affect

a.

what is fixed, false beliefs that are NOT based in reality or consistent with the patient’s religion or culture?

a. delusions

b. illusions

c. hallucinations

a.

T/F illusions (visual misperceptions) do NOT always indicate a mental disorder

TRUE

delusions are often accompanied by anosognosia, which is ________

lack of awareness of a mental disorder

distinguish between paranoid, somatic, and grandiose delusions

paranoid: think they’re being followed

somatic: body dysmorphia

grandiose: inflated self-esteem

what are false sensory impressions/perceptions that occur in the absence of an external stimulus?

a. delusions

b. illusions

c. hallucinations

c.

how do you evaluate cognition in a MSE?

• sensorium

  • level of consciousness/alertness

• memory

  • ability to recall prior info/experiences

• abstraction

  • interpretation of info

checkpoint

which of the following is a component of the mental status exam (MSE)? (SATA)

a. appearance

b. activity

c. speech and language

d. lab values

e. mood and affect

a. b. c. e.

checkpoint

you ask a patient “how are you currently taking your medications?” he begins talking about his neighbor’s dog, before abruptly discussing his co-workers and family. after speaking for five minutes, he states that he is taking his meds as prescribed. which of the following best describes the characteristic of his speech?

a. circumstantial

b. tangential

c. grandiosity

d. pressured

a.

what other medical conditions are patients with mental disorders predisposed to?

• diabetes mellitus

• hyperlipidemia

• cardiac arrhythmias

patients need a careful medical assessment because of __________

overlapping symptoms from differing causes

what are lab screenings useful for? (SATA)

a. monitoring medications

b. ruling out medical causes

c. diagnosing mental disorders

a. b.

what assessment scale measures tardive dyskinesias secondary to antipsychotics and orofacial, truncal, and extremity movements?

a. abnormal involuntary movement scale (AIMS)

b. positive and negative syndrome scale (PANSS)

c. hamilton depression rating scale (HDRS)

d. montgomery asberg depression rating scale (MADRS)

a.

what assessment scale measures psychosis?

a. abnormal involuntary movement scale (AIMS)

b. positive and negative syndrome scale (PANSS)

c. hamilton depression rating scale (HDRS)

d. montgomery asberg depression rating scale (MADRS)

b.

what assessment scale screens patients for drug studies and determines severity of symptoms for standard comparison?

a. abnormal involuntary movement scale (AIMS)

b. positive and negative syndrome scale (PANSS)

c. hamilton depression rating scale (HDRS)

d. montgomery asberg depression rating scale (MADRS)

c.

what assessment scale differentiates between intermediate grades of depression?

a. abnormal involuntary movement scale (AIMS)

b. positive and negative syndrome scale (PANSS)

c. hamilton depression rating scale (HDRS)

d. montgomery asberg depression rating scale (MADRS)

d.

what assessment scale is an objective measure of change in symptoms related to tx and is the standard self rating scale for depression?

a. back depression inventory (BDI)

b. patient health questionnaire (PHQ-9)

c. mood disorder questionnaire (MDQ)

a.

what assessment scale is used in primary care to diagnose and assess severity of depression?

a. back depression inventory (BDI)

b. patient health questionnaire (PHQ-9)

c. mood disorder questionnaire (MDQ)

b.

what assessment scale screens for lifetime history of mania or hypomania, but does NOT assess severity?

a. back depression inventory (BDI)

b. patient health questionnaire (PHQ-9)

c. mood disorder questionnaire (MDQ)

c.

what assessment scale screens patient for drug studies and determines severity of symptoms of bipolar disorder?

a. young mania rating scale (YMRS)

b. hamilton anxiety scale (HAM-A, HAM-AS, HAMRS)

c. yale-brown obssessive-compulsive scale (YBOCS)

a.

what assessment scale is a subscale measure for somatic and psychiatric anxiety?

a. young mania rating scale (YMRS)

b. hamilton anxiety scale (HAM-A, HAM-AS, HAMRS)

c. yale-brown obssessive-compulsive scale (YBOCS)

b.

what assessment scale measures several clusters of obsessions and compulsion, and assesses baseline severity and change in treatment studies?

a. young mania rating scale (YMRS)

b. hamilton anxiety scale (HAM-A, HAM-AS, HAMRS)

c. yale-brown obssessive-compulsive scale (YBOCS)

c.

checkpoint

which of the following assessment scale is correctly paired with what it is assessing?

a. AIMS scale assesses diagnosis of depression

b. PANSS scale assesses psychosis

c. MADRS scale assesses response to treatment in bipolar disorder

d. YBOCS assesses severity of symptoms related to depression

b.