Psych exam 1

Mental health

"the successful adaptation to stressors from the internal or external environment evidenced by thoughts, feelings, and behaviors that are age-appropriate and congruent with local and cultural norms" (Robinson)

Mental illness

"maladaptive responses to stressors… evidenced by thoughts, feelings, and behaviors that are incongruent with local and cultural norms, and interfere with the individual's social, occupational, and/or physical functioning"

DSM-5-TR definition of mental disorder

a syndrome of clinically significant disturbance in cognition, emotional regulation, or behavior reflecting dysfunction in psychological/biological/developmental processes; usually causes significant distress/disability. ⭐ An expected/culturally approved response to a stressor or loss (e.g., grief) is NOT a mental disorder

Anxiety

discomfort/apprehension related to fear of impending danger; source often unknown

Grief

subjective feeling of sorrow/sadness with emotional, physical, social responses to loss

Neurosis (older term, not a current DSM category)

excessive anxiety expressed/altered through defense mechanisms; no loss of reality contact, but functioning impaired

Psychosis

significant thought disturbance, impaired reality testing → delusions, hallucinations, disorganized speech/catatonia

Anosognosia

unawareness of one's own psychological problems/illness (seen in psychosis)

Hippocrates (~400 BCE)

First to view mental illness as physical, not supernatural; theory of 4 humors (4 humors = body fluids) (blood, black bile, yellow bile, phlegm)

Middle Ages (CE 500–1500)

Mental illness → recognized as medical problem; first asylums

Benjamin Rush

"Father of American psychiatry"; humanistic care but still used bloodletting/restraints. (free clinics for the poor)

First U.S. state hospital

Philadelphia, mid-1800s

Dorothea Dix

Lobbied for system of state asylums (1800s); believed mental illness was curable ( & that state hospitals should provide humanistic therapeutic care)

Linda Richards

First American psychiatric nurse (graduated 1873, New England Hospital for Women and Children)

1882

First school of psychiatric nursing — McLean Asylum, Massachusetts

1955

Psychiatric nursing became required curriculum in all undergrad nursing programs

National Mental Health Act of 1946

Funded education of psychiatrists, psychologists, psychiatric nurses; led to graduate-level psych nursing education (around the same time antipsychotic meds helped pts w/ psychosis)

1960s

Community mental health movement began

Maslow's Hierarchy of Needs (bottom → top)

Physiological → Safety/Security → Love/Belonging → Self-Esteem → Self-Actualization

Incomprehensibility

inability to understand the motivation behind behavior

Cultural relativity

"normal" vs "abnormal" depends on the culture's own norms

Alarm reaction

fight-or-flight responses initiated

Stage of resistance

body adapts to stressor; symptoms may disappear if adaptation succeeds

Stage of exhaustion

prolonged stress depletes adaptive energy → diseases of adaptation (headaches, CAD, ulcers, colitis, mental disorders) → can lead to death if unresolved

Mild

Sharpens senses, ↑ motivation/productivity, ↑ perceptual field, optimal learning/functioning; uses simple coping mechanisms (crying, pacing, talking to someone, exercise, drinking, eating, cursing, yawning, laughing etc.)

Moderate

↓ perceptual field, less alert to surroundings, ↓ attention span/concentration, ↑ muscle tension/restlessness; may need help problem-solving; ego defense mechanisms activate

Severe

Perceptual field greatly diminished — focus on one detail or scattered on many; extremely limited attention span; physical sx (headache, palpitations, insomnia) + emotional sx (confusion, dread, horror)

Panic

Unable to focus on anything; misperceptions common; loss of contact with reality possible (hallucinations/delusions); feeling of terror, "going crazy"; can be life-threatening if prolonged

Compensation

Covering up a weakness by emphasizing a more desirable trait

Denial

Refusing to acknowledge a real situation/feelings

Displacement

Transferring feelings from true target to a safer/less threatening one

Identification

Increasing self-worth by adopting traits of an admired person

Intellectualization

Avoiding emotions by focusing on logic/facts

Introjection

Integrating another's beliefs/values into one's own ego

Isolation

Separating a thought/memory from its associated feeling

Projection

Attributing one's own unacceptable feelings to another person

Rationalization

Making excuses/logical-sounding reasons to justify unacceptable behavior

Reaction formation

Expressing the opposite of one's true (unacceptable) feelings

Regression

Retreating to an earlier developmental level under stress

Repression

Involuntary blocking of unpleasant feelings/experiences

Sublimation

Rechanneling unacceptable drives into socially acceptable activities

Suppression

Voluntary blocking of unpleasant feelings ("I'll think about it tomorrow")

Undoing

Symbolically canceling out an intolerable act/thought

Mourning

the grief-related emotions/behaviors process; duration is individual/variable

Prolonged grief disorder

new DSM-5-TR diagnosis (Trauma and Stressor-Related Disorders category); intense distress + impaired functioning enduring beyond 12 months after the loss

Psychobiology

study of biological foundations of cognitive, emotional, behavioral processes

Neuroendocrinology

study of interaction between nervous system & endocrine system, and hormone effects on behavior

Genetics

study of biological transmission of physical/behavioral characteristics parent → offspring

Genotype

total set of genes coded in DNA

Phenotype

physical manifestation of genotype (eye color, height, etc.) — not purely genetic, can be environmentally influenced too

Psychoneuroimmunology (PNI)

study of relationship between immune system, nervous system, and psychological processes (thinking/behavior)

Forebrain

Cerebrum, Diencephalon

Midbrain

Mesencephalon

Hindbrain

Pons, Medulla, Cerebellum

Cerebrum

2 hemispheres joined by corpus callosum (200 million axons); outer layer = cerebral cortex (gray matter = "thinking" structures); left hemisphere = logic/problem-solving; right hemisphere = creative/affect/spatial

Frontal lobes

Voluntary body movement, speaking, thinking, judgment, expression of feelings; prefrontal cortex = regulation/adaptation of emotions, morality, social cognition, decision-making

Parietal lobes

Perception/interpretation of sensory info (touch, pain, taste, body position); language interpretation tied to LEFT parietal lobe

Temporal lobes

Hearing, short-term memory, sense of smell; emotion expression via limbic connection; LEFT temporal lobe (+ left parietal) = language interpretation

Occipital lobes

Visual reception & interpretation

Diencephalon (Thalamus + Hypothalamus)

Connects cerebrum to lower brain structures

Thalamus

Integrates ALL sensory input except smell; blocks minor sensations to allow focus (e.g., ignoring a ticking clock while studying); dopamine effects here linked to neuropsychiatric disorders

Hypothalamus

Regulates pituitary gland (releasing factors), ANS, appetite/temperature/thirst, blood pressure, circadian rhythms (via suprachiasmatic nucleus)

Midbrain (mesencephalon)

Visual, auditory, and righting (balance) reflexes

Pons

Relay station; connects cerebellum/brainstem; cranial nerves V–VIII; respiration & skeletal muscle tone centers; associated with sleep and dreaming

Medulla

Vital centers: HR, BP, respiration; reflex centers for swallowing, sneezing, coughing, vomiting; cranial nerves IX–XII

Cerebellum

Involuntary movement, coordination, muscle tone, posture/equilibrium

Basal ganglia

4 subcortical nuclei (striatum, pallidum, substantia nigra, subthalamic nuclei) — subconscious voluntary movement (arm swing while walking), muscle tone

Gyri

folds

sulci

grooves — ↑ surface area/neurons of cortex

Brainstem

medulla + pons + midbrain

Amygdala

primary gateway for processing novel/ambiguous emotional stimuli (fear, anxiety, panic)

cell body

contains nucleus, keeps neuron alive

dendrites

transmit impulses TOWARD cell body

axon

transmits impulses AWAY from cell body

Myelin

phospholipid sheath (from neuroglia) → insulates, ↑ impulse velocity; white matter = myelinated; gray matter = cell bodies, no myelin

Afferent (sensory)

carry impulses FROM periphery TO CNS

Efferent (motor)

carry impulses FROM CNS TO effectors (muscles/glands)

Interneurons

entirely within CNS; 99% of all nerve cells; responsible for thinking, feelings, learning, language, memory

Synapse

junction between 2 neurons

Synaptic cleft

space between axon terminal & next neuron

Presynaptic neuron

conducts impulse toward synapse

Postsynaptic neuron

conducts impulse away

Reuptake

NT is stored for reuse — key mechanism target of many psychotropic drugs

Sympathetic

dominant during stress; fight-or-flight; originates thoracolumbar spinal cord; ↑ HR/RR, ↓ digestive secretions/peristalsis, blood shunted to vital organs/muscles

Parasympathetic

dominant when relaxed; originates brainstem + sacral spinal cord; normal HR/RR, ↑ secretions/peristalsis (digestion), promotes elimination

Acetylcholine (cholinergic)

Sleep, arousal, pain, movement, memory

Norepinephrine (monoamine)

Mood, cognition, perception, cardiovascular, sleep-wake

Dopamine (monoamine)

Movement/coordination, emotions, reward, judgment, ↓ prolactin release

Serotonin (monoamine)

Sleep/arousal, libido, appetite, mood, aggression, pain

Histamine (monoamine)

Wakefulness, pain, inflammatory response

GABA (inhibitory amino acid)

Slows body activity, ↓ neuron activity

Glycine (inhibitory amino acid)

Recurrent inhibition of motor neurons

Glutamate/Aspartate (excitatory)

Relay sensory info, motor/spinal reflexes

D-Serine (excitatory)

Co-agonist at NMDA receptor

Endorphins/enkephalins (neuropeptide)

Pain/peristalsis modulation

Substance P (neuropeptide)

Pain regulation

Somatostatin (neuropeptide)

Stimulates/inhibits multiple NTs depending on brain region

Acetylcholinesterase

enzyme that inactivates acetylcholine

MAO and COMT

inactivating enzymes for norepinephrine and dopamine

MAO

inactivating enzyme for serotonin and histamine