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49 Cards in this Set

  • Front
  • Back
usually applies to symptoms, fix that which is broken
applies to the entire person (thinking, attitudes, physical, eotional, spiritual, social, lifestyle, intimate relationships)
Phases of the recovery journey
1. Overwhelmed by the disability
2. Struggling with the disability
3. Living with the disability
4. Living beyond the disability
Wellness Recovery Action Plan
Dopamine: neurotransmitter that transmits pleasure signals, may be a factor in craving and addiction
Addictive personality:
Need to feel self worth, need for control, need for intimate contact, need to accomplish something, need to eliminate pain
Substance abuse
Recurrent use that affects work, home, or school...leads to risk behaviors while intoxicated
Substance dependance
Can no longer be controlled and continues despite negative effects, develops tolerance and withdrawal
Mechanism of ETOH
Increases GABA and decreases Glutamate
Wernike's encephalopathy
caused by chronic thiamine deficiency due to alcohol results in lack of coordination, abnormal eye movements, and periods of confusion
Korsakoff's syndrome
Psychosis that results in loss of long-term memory or inability to retain new information
Alcoholic dementia
impaired abstract thinking, poor judgement, personality changes, and memory loss
Management of ETOH withdrawal
Main goal is prevent delirium, benzos are med of choice, dosage determined by symptoms, neuroleptics may be used if delirium ensues, thiamine given in high doses to decrease the rebound effect of CNS as it adapts to no ETOH, encourage fluids and lytes
Disulfiram; takes 14 days to clear the body after discontinuation
approved as tx for opiod abuse as well as etoh, targets alcohol's effects on the brain
Opiate detox
Buprenex and Catapres used together, methadone sometimes used, ibuprofen for aces, hydroxyzine for anxiety, bentyl for abdominal cramps, antacids
An uncomfortable feeling of apprehension or dread that occurs in response to internal or external stimuli and can result in physical, emotional, cognitive, and behavioral symptoms
Examples of anxiety disorders:
Panic disorder c and s agoraphobia, GAD, OCD, Phonias, social anxiety d/o, PTSD, dissociative d/o
Response is hard-wired, doesn't change, triggers can be learned/conditioned
NE and anxiety
Implicated in panic disorder b/c of its effect on the brain which result in the cardiovascular, respiratory, and GI symptomes seen in a panic attack
Mechanism unknown, drugs that facilitate serotonin transmission relieve symptoms of panic attacks, may regulate NE
decreased in those w/ GAD, benxodiazepine antagonist triggers panic attacks in panic d/o but not normal control pts, meds that increase GABA are anxiolytic
Panic d/o diagnostic criteria
Persistent, intense fear, at least four physical or psychological symptoms of anxiety, recurrent and unexpected attacks followed by one month or more of consistent concern about having another attack, worrying about consequences of another attack, or changed behavior out of fear
excessive worry and anxiety about several issues, occurs more days than not for at least six months, little or no control over anxious behavior, no other d/o, significant impairement at work, home, school, no substance or medical causation
SSRI for tx anxiety
Pros: minimal s/e, safer, more effective over long period, less lethal in OD
Cons: takes 4-6 wks to work, sexual s/e, initial increase in anxiety is possible
Pros: rapid alleviation, well-tolerated, useful as PRN, reduces SSRI induced anxiety
Cons: sedation w/ psychomotor and cognitive impairment, potential for abuse and OD, not effective for comorbid depression
Anticonvulsant, off-label use for anxiety, GABA reuptake inhibitor, no derect activity on GABA receptors
Dissociative d/o
Disruptions in the integration of memory, consciousness, and identity, person loses a conscious awareness of behavior, affect, thoughts, and memories, and experiences an alteration in personality, alteration in identity occurs
Dissociative identity d/o
AKA Multiple personality d/o, dx is given when at least two personalities coexist in the same person, hx of childhood abuse, sever, sadistic. Usually triggered as a response to current trauma or abuse, dissociation and repression are used to manage overwhelming emotions, the only way to survive th etrauma is to push it from conscious awareness through self-hypnosis
Tx of dissociative identity d/o
Combination of psychopharmacology and psychotherapy most effective, antidepressant and anxiolytics useful b/c d/o is comorbid w/ a number of other d/o such as anxiety and depression
Diagnostic criteria for personality d/o
based on manifestation of abnormal, inflexible behavior patterns of long duration, traced to adolescence or early adulthood, pervasive across wide range of personal and social situations, cause significant impairment to social or occupation, deviate markedly from norms in 2+ areas: cognition, affectivity, interpersonal functioning, impulse control
General symptoms of personality d/o
Difficulty getting along w/ others, irritable, demanding, hostile, fearful, or manipulative, deviate mardedly from society's expectations and are consistent over time, affects thought, emotion, relationships, and impulse control,
Cluster A
paraniod personality d/o, schiziod personality d/o, schizotypal personality d/o, distrust and suspiciousness in which other's motives interpreted as malevolent, social inhibition, acute disconfort in close relationships
Etiology of personality d/o
Unclear, but in all three there is some evidence of dysfunction in lymbic, reticular, or sympathetic/parasympathetic areas of the brain
Paraniod personality d/o
Suspicious w/o sufficient basis, preoccupied w/ doubts of friends, reluctant to confide b/o of fear, misinterprets remarks or events, unforgiving of insults or injuries, preceives attacks not apparent to others and reacts w/ quick anger
Schiziod personality: asocial
Neither desires nor enjoys close relatioshops, chooses activities that don't involve others, little interest in sexual relations, enjoys few activities, lacks close friendships outside of family, indifferent to praise or criticism, emotionally cold, detached
Schiotypal personality: eccentric
Ideas of reference, odd beliefs inconsistent w/ norms that influence behavior, unusual perceptual experiences, odd thinking and speech, excessively suspicious thinking, inappropriate and/or constricted emotions, lack of friends or confidantes, social anxiety even in familiar situations
Cluster B
Over-emotional, dramatic, impulsive. Borderline personality d/o, antisocial personality, instability in interpersonal relationshops, self-image, and affects and marked impulsivity
Borderline personality: unstable
Frantic efforts to avoid abandonment, intense and unstable relationships, identity disturbance, sudden and dramatic shifts in self-image, suicidal/self-abusive behavior, sudden mood changes, chronic feelings of emptiness and boredom, intense anger w/ less control, stress-related psychosis
Borderline personality: splitting
exaggerated response, all or nothing, projective identification, testing and manipulation, approach avoidance conflict, need-fear dilemma,
Dialectical Behavior therapy
DBT: most effective, combines numerous cognitive and behavior therapy strategies, focus on interconnected behaviors, pts actively participate in goal setting, skill building,
Antisocial personality: aggrandizing
repeated criminal acts, episodes of deceitful behavior, impulsiveness or failure to plan, irritability and or aggressiveness, lack of remorse and consistent indifference
Cluster B types:
Histrionic and narcissistic personality d/o
Histrionic personality:gregarious
discomfort unless center of attention, freq. inappropriate seductive or provocative behavior, reapid shifts and shallow expresion of emotions, draws attention to self w/ physical appearance, overly dramatic speech, easily influenced by others or circumstances, inaccurate perception of intimacy in relationships
Narcissitic personality d/o
inflated sense of self-importance, overly concerned w/ fantasies of success, power, brilliance, beauty, beleives in own specialness, requires excessive admiration, unreasonable sense of entitlement, lacks empathy, often jealous of others, arrogan
Cluster C d/o
Dependent personality d/o, avoidant personality, O-C personality, submissive and clinging behavior r/t an excessive need to be taken care of
Avoidant personality
Avoids work-related activities that involve social contact, unwilling to get involved unless sure to be liked, excessive shyness in intimate relationshops
Dependant personality
difficulty making decisions w/o help, avoids responsibiilty for major life areas, difficulty starting projects, seeks approval, helpless wwhen alone, seeks support when relationship ends,
Obsessive compulsive personality
overly concerned w/ details, loses focus, unable to complete tasks, excessive emphasis on work, overly conscientious about morals, ethics and values, reluctant to delegate tasks