Exam 2 Concept List

Exam 2 Concept List

Therapeutic Communication/Client Feedback

  • Importance of clear, empathetic communication between healthcare provider and client. This fosters trust and enhances the therapeutic relationship, which is essential for effective treatment.

  • Key techniques include:

    • Active Listening: Involves fully concentrating, understanding, responding, and remembering what the client says. It helps clients feel heard and valued.

    • Validation: Recognizing and affirming the client’s feelings and thoughts, creating a supportive environment.

    • Open-Ended Questions: Encouraging clients to express themselves more fully, promoting deeper exploration of their feelings and experiences.

Depression

  • Characterized by a sudden and prolonged change in mood. It's essential to differentiate between situational sadness and clinical depression.

  • Symptoms include:

    • Persistent Sadness: Feelings of hopelessness and emptiness that last for weeks.

    • Loss of Interest: Withdrawal from previously enjoyed activities, leading to social isolation.

    • Changes in Appetite or Sleep Patterns: Significant weight loss or gain, insomnia or hypersomnia.

  • Important to consider treatment options, including various forms of therapy (like cognitive behavioral therapy) and medication (antidepressants) such as Fluoxetine and Sertraline. Regular monitoring for treatment effectiveness and side effects is critical.

Anxiety

  • Commonly used medications to treat anxiety disorders include SSRIs, SNRIs, benzodiazepines (like Lorazepam and Alprazolam), and beta-blockers (like Propranolol).

  • Addressing anxiety includes various interventions like cognitive-behavioral therapy (CBT), exposure therapy, and mindfulness techniques.

Chronic Anxiety Disorders

  • Chronic anxiety disorders are characterized by persistent and excessive worry about various aspects of life. The anxiety may interfere with daily activities and can last for months or even years. Examples include:

    • Generalized Anxiety Disorder (GAD): Excessive worry about different aspects of life, including health, family, and finances.

    • Panic Disorder: Experiencing recurrent panic attacks, which are sudden periods of intense fear and discomfort.

Acute Anxiety Disorders

  • Acute anxiety disorders refer to sudden or short-term anxiety responses that can arise from stressful circumstances or traumatic events. They can include:

    • Acute Stress Disorder (ASD): Symptoms arise after experiencing a traumatic event and can last from 3 days to 4 weeks.

    • Situational Anxiety: Temporary feelings of anxiety triggered by specific situations or events, such as public speaking or tests.

Sertraline (Zoloft)

  • An SSRI (Selective Serotonin Reuptake Inhibitor) commonly prescribed for treating depression and anxiety disorders.

  • Important to monitor for side effects such as nausea, insomnia, weight gain, and sexual dysfunction, as well as evaluating its effectiveness in reducing symptoms.

Malingering/Factitious Disorders vs. Somatic Symptom Illnesses

  • Malingering: Involves intentional falsification of symptoms for secondary gain, such as financial compensation or avoiding responsibilities.

  • Factitious Disorders: Characterized by intentionally producing or exaggerating symptoms for emotional gain or to assume a sick role. No specific medications are used, as treatment focuses on psychotherapy.

  • Somatic Symptom Illnesses: Involve an undue focus on physical symptoms that cannot be fully explained medically, often linked to psychological factors. Diagnosis requires thorough clinical evaluations and history-taking explorations. Treatment may include medications for anxiety or depression if indicated.

PTSD (Post-Traumatic Stress Disorder)

  • Interventions include therapies like Eye Movement Desensitization and Reprocessing (EMDR), medication management (SSRIs like Sertraline, Fluoxetine, and SNRIs like Venlafaxine), and support groups to help individuals cope.

  • Symptoms can include flashbacks, avoidance of reminders of the trauma, and hyperarousal (e.g., heightened anxiety, irritability).

  • Han Selye’s Adaptation Syndrome is a critical theory that relates to stress response and coping mechanisms, emphasizing the physical effects of chronic stress on mental health.

OCD (Obsessive-Compulsive Disorder)

  • Types of behavior associated include obsessive, intrusive thoughts and compulsive actions aimed at reducing the anxiety caused by these thoughts.

  • Individuals often perform compulsions (such as repetitive checking, cleaning, or counting) to alleviate anxiety but find these actions only provide temporary relief. Treatment often includes SSRIs like Fluoxetine or Sertraline and cognitive-behavioral therapy.

Assessing Suicide Risk

  • Key assessment components for suicide risk include:

    • History of previous attempts, which is one of the strongest predictors of future attempts.

    • Current mental state, including suicidal ideation, intent, and plan.

    • Social supports, including family dynamics, friendships, and community ties.

  • Developing a comprehensive safety plan and implementing intervention strategies is vital in crisis situations.

MAOI Dietary Restrictions

  • MAOIs (Monoamine Oxidase Inhibitors), such as Phenelzine, require significant dietary restrictions to avert hypertensive crises from tyramine-rich foods.

  • Foods high in tyramine include aged cheeses, cured meats, fermented products, and certain alcoholic beverages, which must be strictly avoided by patients.

Illness Anxiety Disorder

  • Previously known as hypochondriasis; this involves excessive concern or fear over having a serious illness, often leading to frequent medical consultations and tests. Treatment may include psychotherapy and medications like SSRIs (such as Fluoxetine) if anxiety levels are high.

Fluoxetine

  • Another SSRI used to treat depression and anxiety, noted for its generally favorable side effect profile. Regular monitoring is essential for side effects and overall effectiveness in managing symptoms.

Serotonin Syndrome

  • A potentially life-threatening condition caused by an excess of serotonin in the brain, often due to medication interactions or overdose.

  • Symptoms include agitation, confusion, rapid heart rate, hypertension, dilated pupils, and in severe cases, seizures or loss of consciousness.

Lithium

  • A mood stabilizer frequently used for Bipolar Disorder, requiring careful therapeutic monitoring to maintain effective blood levels. It is used primarily to manage manic and depressive episodes.

  • Management of Lithium:

    • Regularly monitor serum lithium levels to maintain therapeutic range (0.6-1.2 mEq/L).

    • Assess for signs of toxicity, such as nausea, tremors, and confusion.

    • Ensure adequate hydration and sodium intake, as dehydration can increase lithium levels.

  • Diet Adherence:

    • Advise patients to maintain a consistent sodium intake, as fluctuations can affect lithium levels.

    • Patients should be cautioned to avoid excessive caffeine and alcohol, as these can further impact lithium metabolism.

  • Important to assess for side effects such as tremors, potential weight gain, thyroid issues, and renal function changes.

Bipolar Disorder

  • Types of Bipolar Disorders:

    • Bipolar I Disorder: Characterized by one or more manic episodes, which may be preceded or followed by hypomanic or major depressive episodes.

    • Bipolar II Disorder: Involves a pattern of depressive episodes and at least one hypomanic episode, but no full-blown manic episodes.

    • Cyclothymic Disorder: A milder form of bipolar disorder consisting of numerous periods of hypomanic symptoms and periods of depressive symptoms lasting for at least two years.

  • Management may involve mood stabilizers (like Lithium), antipsychotics (like Quetiapine and Olanzapine), and antidepressants for depressive episodes, requiring ongoing monitoring for mood changes and medication adherence.

  • Symptoms include manic episodes with elevated mood, increased energy, and depressive episodes characterized by sadness and lethargy.

Depression in Older Adults

  • Older adults may exhibit atypical symptoms, including cognitive changes, increased somatic complaints, and possible overlap with dementia symptoms. Mental health treatment must take into account polypharmacy and interactions with other medications.

  • Recommended medications may include SSRIs, and non-pharmacological interventions are often considered due to sensitivity to medications in this population.

Dissociation and Depersonalization

  • Dissociation: Involves an emotional or cognitive disconnection from thoughts, feelings, or sense of identity, often as a defense mechanism against trauma.

  • Depersonalization: A specific form of dissociation where individuals feel detached from their body or thoughts, leading to feelings of unreality or detachment from self. Treatment often includes psychotherapy and, in some cases, medication for associated anxiety symptoms.

Nonverbal Communication

  • Nonverbal cues such as body language, eye contact, facial expressions, and tone of voice play a critical role in therapeutic relationships, influencing how messages are received and understood.

Malingering

  • Defined as the intentional production of false or grossly exaggerated symptoms to achieve some external benefit, such as evading work or obtaining medications. No specific medication is prescribed; treatment focuses on underlying issues.

Amitriptyline

  • A tricyclic antidepressant used for treating depression and certain types of chronic pain, particularly neuropathic pain.

  • Close monitoring for anticholinergic side effects (e.g., dry mouth, constipation, urinary retention) is necessary, especially in older adult patients.

St. John’s Wort and SSRIs, MAOIs, etc.

  • Herbal treatments like St. John’s Wort can interact dangerously with SSRIs and MAOIs, possibly leading to serotonin syndrome. Careful consideration of complementary therapies and potential interactions is critical for patient safety.

Touching Patients

  • Establishing and respecting professional boundaries is vital when interacting with patients; any touch should be appropriate, consensual, and in line with therapeutic goals.

Dissociative Identity Disorder

  • Characterized by the presence of two or more distinct personality states or identities, often as a result of severe trauma during early development. Treatment focuses on integration of the identities and addressing the underlying trauma, often involving psychotherapy and medication for associated symptoms.

Systematic Desensitization

  • A behavioral therapy method used for phobias and anxiety disorders, involving gradual exposure to the feared object or context in a controlled manner to diminish anxiety.

Valerian

  • An herbal supplement claimed to aid in anxiety and sleep disorders, though its efficacy and safety should be rigorously evaluated, particularly when combined with pharmaceuticals.

Somatization Disorder

  • Involves individuals experiencing physical symptoms without a clear medical explanation, often tied to psychological factors and stressors. Treatment generally involves psychotherapy and symptom management, possibly including medications for anxiety or depression.

DSM (Diagnostic and Statistical Manual of Mental Disorders)

  • The standard classification of mental disorders used by mental health professionals for diagnosis purposes, providing specific criteria and associated features.

Seasonal Affective Disorder

  • A type of depression that correlates with changes in seasons, most notably observed during winter months, often linked to reduced sunlight exposure. Treatment often includes light therapy, antidepressants (like SSRIs), and psychotherapy.

Benzodiazepines and ETOH (Alcohol)

  • Great caution is necessary when combining benzodiazepines with alcohol, as this combination significantly increases the risk of respiratory depression and overdose.

SSRI Side Effects

  • Common side effects associated with SSRIs include nausea, weight gain, sexual dysfunction, and insomnia. Patients should be adequately informed about these potential effects and monitored closely.

Conversion Disorder

  • Characterized by neurological symptoms (such as paralysis, blindness, or seizures) that cannot be explained by any medical evaluation, often associated with psychological stress or trauma. Treatment typically involves psychotherapy and symptom management.

Mania Speech

  • Typically involves rapid, pressured speech, racing thoughts, and impulsive communication, often experienced during manic episodes of Bipolar Disorder.

Dissociative Amnesia

  • Characterized by the inability to recall important personal information, usually following traumatic or highly stressful events, which can significantly impair daily functioning. Treatment generally involves therapy focusing on trauma and may include medications for associated symptoms.

MAOI Medications and Definitions

  • MAOIs (Monoamine Oxidase Inhibitors): A class of antidepressants used primarily to treat major depressive disorders. These medications function by inhibiting the monoamine oxidase enzyme, which breaks down neurotransmitters such as serotonin, norepinephrine, and dopamine. By preventing this breakdown, MAOIs increase the levels of these neurotransmitters in the brain.

  • Phenelzine (Nardil): An irreversible MAOI used for the treatment of depression, anxiety disorders, and certain phobias. It may also be used in cases where other antidepressant therapies have failed. Patients using Phenelzine should avoid tyramine-rich foods to prevent hypertensive crises.

  • Tranylcypromine (Parnate): Another irreversible MAOI effective in treating depression. It works similarly to Phenelzine but may have different side effects and interactions. Like other MAOIs, it necessitates dietary restrictions to avoid serious health risks.

  • Isocarboxazid (Marplan): An MAOI used for treating depression, particularly in patients who have not responded to other medications. It requires cautious use due to potential dietary restrictions and side effects.

  • Selegiline (Eldepryl, Zelapar): Although primarily used in treating Parkinson's disease, at higher doses, it acts as an MAOI for depression. It selectively inhibits type B monoamine oxidase, and when administered in a transdermal patch, it allows for lower risks of dietary interactions than traditional oral MAOIs.