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58 Cards in this Set

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What is the science that deals with mental processes and behavior?
Psychology
What is a person trained and educated to perform psychological research, testing, and therapy.
Psychologist
What is the branch of medicine that deals with diagnoisis, tx, prevention of mental and emotional disorders?
Psychiatry
A physician who specializes in:
psychiatrist
A mark of infamy or disgrace;
sign of moral blemish;
stain or reproach caused by dishonorable conduct;
reproachful characterization.

A mark or characteristic indicative of a history of a disease or abnormality
STIGMA
What can I do to COMBAT stigma?
1. Educate: mental illness is really disease, common, treatable.

2. Share your own experiences with mental illness

3. Support people with mental illness.
Explain the usefulness of DSM-IV:
1. Published by the APA.
2. Guides clinicians to diagnose and describes psychiatric disorders.
3. Used in conjunction with clinical judgement
4. Creates consistency for clinicians and researchers.
5. Covers Children and Adults
6. Includes statistics, background info, ICD-9.
AXIS I:
- CLINICAL DISORDER, OTHER conditions that require clinical attention.

1. Dx: Schizo, depression, body dysmorphic disorder.
2. REPORT all disorders: more than one psychiatric dx.
- but list most important problem first.
Axis II:
- Personality disorders or mental retardation.
+ nonmaladaptive personality features and defense mechanism:
Such as: histrionic, narcissistic, antisocial, borderline, personality disorder.
- Notes development disorders:
mental retardation and autistic disorders
- "principal diagnosis" or "reason for visit"
- "deferred" vs. "none"
Axis III:
General Medical Condition revelevant to pt's mental disorder:
1. alzheimer's disease, diabetes, hypothyro, HTN, gout, osteo
2. worsen to mental disorder
3. lead to psychological reactions
4. influence tx.
Axis IV:
Psychosocial and Enviromental Problems:
1. family or personal stress
2. positive or negative life stressors
3. enviromental difficulty.
, etc.within a year.
Axis V:
Global Assessment of Functioning:
- clinican assesment indication patients current level of function.
- 0 = unable to assess
- 100 = superior functioning
How to overcome a CHALLENGING PT: altered mental status
1. Redirect the patient politely.
2. Be calm and respectful
3. Ask directed questions with simply answers.
What types of history should be getting from an psychiatric patient:
1. Psychiatric History
2. Social History
3. Medication History
4. Mental Status Examination (MSE)
Mental Status Examination:
1. Appearance, activity, attitude toward interviewer
2. Mood and Affect
3. Speech, language, sensorium
4. Insight and Intelligence
5. Thought and perceptual disturbances.
What is mood?
- sustained feelings
** subjectively reported by patient.
What is the affect?
- current observable emotion.
** observational reported by clinican
** fluctuating changes in emotion.

1. blunted, flat, inappropriate, labile, restricted.
What is speech, language, sensorium?
- quality, rate, volume, sensorium (level of conciousness/alertness of patient..)
What is the insight and intelligence?
refers to patients awarness taht they have a mental illness and the consequences mental illness has on their life.
- poor insight = noncompliant with meds
- average, below or above average.
Thougth Content;
normal vs. abnormal
type of delusions
Perceptual disturbances:
Hallucinations vs. illusions.
Affect
describes the patient’s current emotional tone, as expressed through facial expression and tone of voice. Affect refers to more fluctuating changes in emotion (“weather”). Affect is objectively observed by the clinician. Examples include sadness, elation, and anger.
Blunted Effect
the intensity of emotional expression is reduced, but not absent
Flat Effect
no change in expression occurs throughout the course of the interview, as in schizophrenia or depression. There is an absence or near absence of any signs of expression.
Inappropriate Effect
when affect observed does not match the behavior displayed by a patient. For example, a depressed patient who is laughing would display inappropriate affect.
labile
abnormal variability in affect with repeated, rapid, and abrupt shifts in expression
restricted or constricted
mild reduction in the range and intensity of emotional expression
alogia
poverty of sepech, not able to carry on a logical converstation
anhedonia
lack of interest, in previously enjoyed activities
avolition
lack of goal-directed behavior, lack of motivation
blocking
a person suddenly stops speaking without an obvious reason
Catatonic behavior
motor abnormalities including patients with rigid posture, an absence of movement or excessive types of certain movements (purposeless agitation not influenced by external stimuli) and failure to communicate effectively (i.e. echolalia – senseless repetition or echopraxia – repetition by imitation of another’s movements). Rule out paranoia or medication-induced adverse effects.
Circumstantial speech
lacks a clear direction because of excess unnecessary information, although the point is eventuallly made.
Compulsions
actions performed in response to the obsessions or to control anxiety associated with the obsession.
Delusions
fixed falso reliefs that not based in reality or consistent with the pts religion or culture. Maybe persuctory, bizarre, grandiose, jealousy, somatic.
bizarre
a phenomenon that the person's culture would regard as totally implausible
grandiose
inflated appraisal of one's worth, power, knowledge, importance, or identity.
jealousy
one's sexual partner is unfaithful
persecutory
the central theme of teh delusion is that one is being attacked, harassed, cheated, persecuted, conspired against.
Somatic
related to the appearance of function of one's body.
flight of ideas
over-productive, rapid speech during which the patient jumps rapidly from one idea to the next. These ideas are connected to each other by association, distracting stimuli, or plays on words.
hallucinations
false sensory impressions or perceptions that occur in absence of an external stimulus. May be auditory, visual, olfactory, or gustatory and may be continuous or intermittent.
Ideas of reference
the belief that an external event has a meaning that is specific to the person. For example, the belief that a news broadcast is speaking specifically to them
Illusions
visual misperceptions involving a misinterpretation of a real sensory stimulus. This may be experienced by people without psychiatric illness
insight
refers to patient awareness that they have a mental illness and the consequences the mental illness will has on their life
Judgement
is the ability to make decisions appropriate to the situation and may be impaired in a variety of mental illness
judgement
is the ability to make decisions appropriate to the situation and may be impaired in a variety of mental illnesses
Looseness of association (“derailment”)
– when there is no connection between thoughts. For example, a patient may believe that the blue flag outside their window is a sign that the world is going to end.
Mood –
describes sustained feelings (“climate”). Mood is subjectively reported by the patient and may be described as euthymic, depressed, irritable, etc.
.
Mutism –
the patient does not respond even though they are aware of the discussion
Obsessions
– unwanted thoughts or ideas that intrude into a person’s thinking. The patient recognizes these as abnormal
Over-activity –
Over-activity – an increase in purposeful movements or agitation and an include pacing; hand wringing; picking at clothing, skin, or hair; inability to sit still during the interview; excessive hand gestures
Perseveration
– repetition of an original answer to subsequent questions
Pressured speech
Pressured speech – speech that is increased in amount, accelerated, and difficult or impossible to interpret. Often patients continue to talk, even if no one is listening.
Tangential Speech
Tangential speech – like circumstantial speech, however the point is never made
Thought broadcasting
– the belief that one’s thoughts are broadcasted out loud so they are available to others
Thought blocking
– usually occurs when a hallucination or delusion intrudes into the person’s thinking or when upsetting issues are discussed.
Thought insertion
– the idea that one’s thoughts are not their own, but rather inserted into their mind.
Under-activity
– patient moves less than expected