1025 exam 3 study

Mentally Healthy

The successful adaptation to stressors from the internal or external environment. Thoughts, behaviors, and feelings are congruent with cultural and local norms as well as age-appropriate

Mentally unwell

Maladaptive responses to stressors shown by thoughts, feelings, and behaviors that are incongruent with local and cultural norms and interfere with persons life

Etiologies of mental illnesses

Biological and psychodynamic theories

Biological theories include

Genetic theories and neurochemical theories

Psychodynamic theories include

Psychoanalytic theories (freud), interpersonal theories, behavioral theories

Defense Mechanisms

Protect yourself and cope with emotionally painful thoughts, feelings, or events. Most are unconscious and people aren’t aware they’re doing it.

compensation

Overachievement in one area to offset real or perceived deficiencies in another area. (sucks at basketball but really good student)

conversion

expression of an emotional conflict through the development of a physical symptom, usually sensorimotor in nature

denial

failure to admit reality of a situation or to acknowledge an unbearable condition

Displacement

ventilation of intense feelings toward someone else, less threatening than the one who originally caused the feelings.

dissociation

dealing with emotional conflict by temporary alteration in consciousness or identity (im not going to think about my exam coming up right now)

fixation

A persons personality being stuck at a certain developmental stage from unsuccessful completion of tasks in that stage.

identification

modeling actions or opinions of influential others while searching for identity or aspiring to reach a goal

intellectualization

separation of the emotions of a painful event or situation from the facts involved: Acknowledging the fact not the emotions

introjection

accepting another persons attitudes, beliefs, and values as your own. (a child w/ parents constantly disappointed in them will internalize those beliefs and think it about themself.)

projection

Unconscious blaming of unacceptable inclinations or thoughts on an external object. (cheating bf always accusing girlfriend of cheating)

rationalization

excusing own behavior to avoid guilt, responsibility, conflict anxiety, or loss of self respect. (not getting accepted to your dream job and saying “i didn’t really wanna do it anyways” vs. admitting disappointment)

Reaction Formation

acting the opposite of what one feels or thinks. (little boys hit/are mean to girls they like)

Regression

moving back to a previous developmental stage to feel safe and have needs met. (Only child gets new sibling and wants binky again)

repression

Excluding emotionally or anxiety provoking thoughts and feelings from conscious awareness. (you don’t REalize you’re doing it)

resistance

Overt or covert antagonism toward remembering or processing anxiety-producing information. (using humor as a shield or changing the subject)

substitution (sublimation)

replacing the desired gratification with one that is more readily available. (jumping into a new relationship after painfully being broken up with) Or socially acceptable for sublimation (going to the gym instead of fighting to deal w/ anger)

Supression

Conscious exclusion of unacceptable thoughts and feelings from conscious behavior

undoing

exhibiting acceptable behavior to make up for or negate unacceptable behavior. (bf is mean to you and buys you flowers to undo it with no sorry or conversation)

Psychiatric assessment- how to conduct interview

safe, comfortable, private environment. Input from family if applicable, open ended questions (tell me about what’s been happening to you) and close ended questions (how many hours did you sleep last night)

Psych assessment components

pt history including developmental stage, general appearance including unsusual movement or mannerisms or eye contact

tremors, tics, rocking, flicking, unique mannerisms, hyperactivity, restless movement, aggressiveness

abnormal motor behavior assessed during psychiatric assessment

Rigidity, echopraxia, psychomotor retardation, waxy flexibility, automatisms

Abnormal motor behavior: Rigidity = stiffness, Echopraxia = mimicking movement, psych retardation = slow movement, waxy flexibility= stays in one position, automatisms = repeated purposeless behaviors.

mood

The patients sustained and enduring emotional state/ (happy, sad, depressed, irritable, anxious)

affect: inappropriate, bland/flat, and apathy

Affect: outward expression of the patient’s emotional state.

inappropriate: individual emotional tone incongruent with circumstances

bland/flat: void of emotional tone

Apathy: indifference to or disinterest in the environment

Form of thought. associative looseness, clang associations, circumstantiality

associative looseness: jump ideas

clang associations: rhyming/ making sounds

Circumstantiality: digresses from the point but eventually gets to it

concrete thinking, confabulation, echolalia

Concrete thinking: literal

Confabulation: honest lying

Echolalia: repeating words aka parrot talk

flight of ideas, ideas of reference, mutism, neologism

Flight of ideas: racing thoughts

Ideas of reference: thinks things are directed at them

mutism: cant or wont speak

Neologism: made up language

perseveration, tangentiality, word salad

perseveration: wont let the thought go

tangentiality: off on tangents

Word-salad: random (non made up) words

content of thought

delusions, suicidal/homicidal ideas, paranoia, obsessions, magical thinking, nihilistic (part of the body doesn’t exist)

nihilistic

part of the body doesn’t exist to patient. (patient telling us Im not eating cause i have no stomach)

thought broadcasting, insertion, withdrawal, and blocking

Broadcasting: belief that ones silent thoughts are being projected

insertion: belief that thoughts are being placed into ones mind

Withdrawal: the belief that an external force, person, or device is stealing or deleting thoughts from their mind

blocking: persons thoughts wiped blank mid convo

oriented, memory, ability to concentrate/calculate, abstract thinking

sensory and cognitive ability

hallucinations

false sensory perceptions not associated with real external stimuli . Auditory, visual, tactile, smell, taste

illusions

misperception of a real external stimulus

depersonalization

altered perception of the self

derealization

altered perception of the environment

judgment

ability to interpret the environment and situation correctly and adapt behavior and decisions accordingly

insight

ability to understand the true nature of a situation of a situation and accept some personal responsibility

self concept

ones view of personal worth and dignity. Personal view of self, descriptions of self, personal qualities

roles and relationships

nurse assesses roles and how the patient feels about them. (do you feel close to your family)

physiologic and self care considerations

eating habits, sleeping patterns, health problems, compliance with prescribed medications, ability to perform ADL’s

syntonic vs. dystonic

syntonic= lack of personal insight

dystonic= has personal insight

right to refuse medication

part of patients bill of rights. only court approval can override the patients decision

right to least restrictive treatment options

must attempt to provide treatment in a manner that least restricts the freedom of patients

restraints and seclusion

attempt de-escalation first. keep voice calm and low, verbalize patients options, assure your own safety as well. only used as last resort

when must psychiatrist see patient face to face after being restrained

within one hour

voluntary admission

person directly seeks services, individual may sign out of treatment at any time if not deemed harmful to self or others

involuntary hospitialization

in an emergency if client is dangerous to self or others, for observation and treatment of mentally ill people, when an individual is unable to take care of personal needs

describe community mental health centers

community-based is the best option. focuses on rehabilitation, vocational skills, education, socialization and management of symptoms