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84 Cards in this Set

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  • Back
Describe Freud's theory
Psychoanalytic theorist who believed in the personality components ID, Ego, Superego He also believed in Ego defense mechanisms and the 5 stages of psychosexual development
What is the ID
ID = the innate desires, pleasure seeking, aggression, and sexual impulse (the devil)
What is the EGO
EGO = the mature adaptive behavior the mediator of the ID and SUPEREGO
(the person)
What is the SUPEREGO
SUPEREGO = Moral, ethical, values, parental
(the angel)
Define Repression
The exclusion of unpleasant or unwanted experiences, emotions or ideas from conscious awareness. It is considered the cornerstone of defense mechanisms and it is the first line of psychological defense against anxiety.
EXAMPLE: Woman has no memory of yesterday's rape.
Define sublimation
An unconscious process of substituting constructive and socially acceptable activity for strong impulses that are not acceptable in their original form. Usually these impulses are aggressive or sexual in nature.
EXAMPLE: A mother whose son was killed by a drunk driver channels her anger and energy into being president of MADD
Define regression
The ego returns to an earlier, more comforting, although less mature way of behaving.
EXAMPLE: An adult who cannot have own way, pouts and whines and behaves in a manner that got him his own way as a child
Define displacement
A transfer of emotions associated with a particular person, object, or situation to another person, object, or situation that is non-threatening.
EXAMPLE: Boss yells at man; man yells at wife; wife yells at child; child kicks the dog
Define projection
The person unconsciously rejects emotionally unacceptable features and attributes them to other people, objects, or situations through projection
EXAMPLE: Blaming or scapegoating
Define compensation
Make up for deficits in one area by excelling in another area in order to raise or maintain self-esteem
EXAMPLE: An unsuccessful actor becomes a successful playwright
Define reaction-formation
Unacceptable feelings or behaviors are kept out of awareness by developing the opposite behavior or emotion
EXAMPLE: Ann hates nursing. She attends nursing school to please her parents. During career day she speaks to perspective students about the excellence of nursing as a career
Define denial
Escaping unpleasant realities by ignoring their existence
EXAMPLE: A woman whose health has deteriorated because of alcohol abuse, denies she has a problem with alcohol by saying she can stop drinking whenever she wants
Define conversion
Transforming anxiety on an unconscious level to a physical symptom that has no organic cause
EXAMPLE: A professor develops laryngitis on the day he or she is scheduled to defend a research proposal to a group of peers
Define undoing
Makes up for an act or communication. It can be viewed as cleansing oneself of a perceived unacceptable act or thought
EXAMPLE: Giving a gift to undo an argument or compulsive hand washing
Define rationalization
Justifying illogical or unreasonable ideas, actions, or feelings by developing acceptable explanation that satisfy the teller as well as the listener
EXAMPLE: Everybody cheats, so why shouldn't I?
Define identification
An unconscious mechanism used to protect the person against anxiety and loss by imitation of mannerisms or behaviors of a person or group
EXAMPLE: Hero worship
Define introjection
Intense identification in which a person incorporates or takes into his or her own personality qualities or values of another person with whom or with which intense emotional ties exist
EXAMPLE: A child integrates their parents' value system into the process of conscience formation. A child says to a friend, Dont cheat it's wrong
Define suppression
The conscious putting off of awareness of disturbing situations or feelings
EXAMPLE: A student who has been studying for the State Board Exam says, I Can't worry about paying my rent until after my exam tomorrow
Define intellectualization
Avoiding unacceptable emotions by focusing on the intellectual aspects
EXAMPLE:focusing on the details of a funeral as opposed to the sadness and grief
Diagnostic and statistical manual of mental disorders
Define AXIS I
Major psychiatric disorders, except mental retardation and personality disorders
EXAMPLE: Recurrent Major Depression
Define AXIS II
Personality disorders and developmental disorders
EXAMPLE: Mild Mental Retardation
Physical disorders and conditions
EXAMPLE: Colitis
Define AXIS IV
Severity of psychosocial stressors - rated on scale
EXAMPLE: Marital separation, loss of employment - rated severe
Define AXIS V
Global assessment of functioning (highest level of adaptive functioning)
EXAMPLE: Suicidal Idealation - 50
What are the five stages of freud's psychosexual development
Oral - birth to 18 months
Anal - 18-36 months
Phallic/oedipal - 3-5 yrs
Latency - 5-11 or 13 yrs
Genital - 11-13 yrs
Define transference
Happens when the client displaces onto the therapist attitudes and feelings that the client originally experienced in other relationships
Define countertransference
Happens when the therapist displaces onto the client attitudes or feelings from his or her past
What are eriksons eight psychosocial stages of development
Trust vs mistrust (infant)
Autonomy vs shame and doubt (toddler)
Initiative vs guilt (preschool)
Industry vs inferiority (school age)
Identity vs role confusion (adolescence)
Intimacy vs isolation (young adult)
Generativity vs stagnation (middle adult)
Ego integrity vs despair (maturity)
What are sullivans Interpersonal three developmental cognitive modes of experience
Prototaxic mode = characteristics of infancy and childhood, involves brief unconnected experiences that have no relation to each other
Parataxic mode = begins in early childhood as the child begins to connect experiences in sequence
Syntaxic mode = begins to appear in school-age children and becomes more predominant in preadolescence, the person begins to perceive himself or herself and the world within the context of the environment and can analyze experiences in a variet of settings
Abnormalities in the frontal lobes are associated with
schizophrenia, attentiondeficit/hyperactivity disorder and dementia
Disturbances in the limbic system have been implicated in
memory loss seen in dementia poor impulse and emotional control psychotic or manic behavior
Define neurotransmitters
chemical substancdes manufactured in the neuron that aid in the transmission of information throughout the body. They either excite or stimulate an action in the cells (excitatory) or inhibit or stop and action (inhibitory)
What are the major types of neurotransmitters
Norepinephrine (noradrenaline)
Epinephrine (adrenaline)
Gamma-aminobutyric acid (GABA)
generally excitatory implicated in schizophrenia, psychoses as well as movement disorders such as parkinsons disease
Norepinephrine and its derivative epinephrine
Neurotransmitter also known as noradrenaline and adrenaline excess norepinephrine has been implicated in a variety of anxiety disorders; deficits may affect memory loss, social withdrawal, and depression epinephrine also controls the fight-or-flight response in the peripheral nervous system
Neurotransmitter found only in the brain plays an important role in anxiety and mood disorders and schizophrenia. It has also been found to play a role in the delusions, hallucinations, and withdrawn behavior seen in schizophrenia. It is also derived from tryptophan
neurotransmitter found in the brain, spinal cord, and peripheral nervous system, particularly at the neuromuscular junction of skeletal muscle. studies have shown that persons with Alzheimer's disease have a decreased number of acetylcholine-secreting neurons, and persons with myasthenia gravis have a reduced number of acetylcholine receptors
Gamma-aminobutyric acid (GABA)
amino acid and is the major inhibitory neurotransmitter in the brain and has been found to modulate other neurotransmitter systems rather than providing a dircet stimulus Benzodiazapines increase GABA function
What is the Physiologic effect of Dopamine
Excitatory Controls complex movements, motivation, cognition; regulates emotional response
What is the Physiologic effect of Norepinephrine (noradrenaline)
Excitatory Changes in attention, learning and memory, sleep and wakefulness, mood
What is the Physiologic effect of Epinephrine (adrenaline)
Excitatory Fight or flight response
What is the Physiologic effect of Serotonin
Inhibitory Control of food intake, sleep and wakefulness, temperature regulation, pain control, sexual behaviors, regulation of emotions
What is the Physiologic effect of Acetylcholine
Excitatory or inhibitory Sleep and wakefulness cycle; signals muscles to become alert
What is the Physiologic effect of Neuropeptides
Neuromodulators Enhance, prolong, inhibit, or limit the effects of principal neurotransmitters
What is the Physiologic effect of GABA
Inhibitory Modulates other neurotransmitters
Define Depot injection
a time released form of medication for maintenance therapy. The vehicle for these injections is sesame oil so it is absorbed slowly over time
Name two antipsychotics that are available in depot injection
Fluphenazine (Prolix): 7 to 28 day duration
Haloperidol (Haldol) 4 week duration
condition must be stabilized with oral types befor administering depot injections
Define Antipsychotic drugs
Also known as neuroleptics and are used to treat symptoms of psychosis such as delusions and hallucinations They work by blocking receptors of dopamine
What are some main side effects of antipsychotic drugs
Extrapyramidal symptoms (EPS)
Neuroleptic malignant syndrome (NMS)
Tardive dyskinesia (TD)
Anticholinergic side effects
What is Extrapyramidal symptoms (EPS)
These are serious neurologic symtoms they include acute dystonia, pseudoparkinsonism and akathisia
Define Acute Dystonia
includes acute muscular rigidity and cramping, a stiff or thick tongue with difficulty swallowing, and in severe cases laryngospasm and respiratory difficulties usually occurs in first week of treatment
Define torticollis r/t acute dystonia
twisted head and neck
Define opisthotonus r/t acute dystonia
tightness in the entire body with the head back and an arched neck
Define oculogyric crisis r/t acute dystonia
eyes rolled back in a locked position
What is the TX for persons with Acute Dystonia symptoms
anticholinergic drugs such as IM benztropine mesylate (cogentin) or IM or IV diphenhydramine (benadryl)
Define pseudoparkinsonism
symptoms resemble those of parkinson's disease and include a stiff, stooped posture; masklike facies; drcreased arm swing; a shuffling, festinating gait with small steps; cogwheel rigidity; drooling; tremor; bradycardia; AND COARSE PILL-ROLLING MOVEMENTS OF THE THUMB AND FINGERS WHILE AT REST
TX change to another antipsychotic med or by adding an oral anticholinergic agent or amantadine
Define akathisia
The intense need to move about. The client appears restless or anxious and agitated, often with rigid posture or gait and lack of spontaneous gestures
TX change in antipsychotic med or that additon of an oral agent such as a beta-blocker, anticholinergic, or benzodiazepine
Define Neuroleptic malignant syndrome
potentially fatal, idiosyncratic reation to an antipsychotic drug. The major symptoms are rigidity, high fever, autonomic instability, such as unstable blood pressure, diaphoresis, and pallor, delirium and elevated levels of enzymes particularly CPK. Clients usually are confused and often mute; may fluctuate from agitation to stupor
TX immediate discontinuance of all antipsychotic medications and the institution of supportive medical care, such a srehydration and hypothermia until stabalizes
Define Tardive dyskinesia
a syndrome of permanent, involuntary movements, is most commonly caused by the long term use of typical antipsychotic drugs. Symptoms incluced involuntary movements of the tongue, facial and neck muscles, upper and lower extremities, and truncal musculature, tongue thrusting and protrusion, lip smacking, blinking, grimacing, and other excessive, unnescessary facial movements The involuntary movement scale is used to assess TD;
TD is irreversible
Define Anticholinergic side effects
side effectgs used with antipsychotics and include orthostatic hypotension, dry mouth, constipation, urinary hesitance or retention, blurred near vision, dry eyes, photophobia, nasal congestion, and decreased memory; usually decrease in 3-4 wks
What are some other common side effects of antipsychotic drugs
increased blood prolactin levels which will cause breast enlargement and tenderness in men and women; diminished libido and erectile and orgasmic sysfunction, menstrual irregularities, and an increase risk for breast cancer
What are some typical antipsychotic medications
thorazine, trilafon, prolixin, mellaril, serentil, stelazine, navane, haldol, loxitane, moban
What are some atypical antipsychotics
clozaril, risperdol, zyprexa, seroquel
Define Antidepressants
primarily used in the tx of major depressive illness, panic disorder and other anxiety disorders, bipolar depression and psychotic depression
What are the four groups of antidepressants
Name some Cyclic compounds (antidepressants)
tofranil, norpramin, elavil, pamelor, sinequan, surmontil, vivactil, LUDIOMIL, ASENDIN, anafranil
Info about cyclic compounds
Block cholinergic receptors, resulting in an anticholinergic effects; Used for antidepressants but can be used for insomnia and panic disorders; more side effects then SSRI's including varying degrees of sedation, orthostatic hypotension, anticholinergic side effects, they are also lethal if taken in an overdose
What is ludiomil
tetracyclic antidepressant that may cause seizures, especially in clients with hx of alcoholism
What is asendin
tretracyclic antidepressant used judiciously since it has similar side effect to the antipsychotic medications
What are some MAOI's
Parnate, nardil, marplan eldepryl
What are some side effects of MAOI's
Sedation, insomnia, weight gain, sexual dysfunction Orthostatic hypotension, nausea, hypertensive crisis if foods with tyramine are eaten or ineraction with other antidepressants (14 day gap)
What are the foods to avoid when taking MAOI's
Cheese except cottage cheese & cream
Aged or cured meat or fish
Broad bean pods, tofu, soybeans
Bananas, rasberries
Draft beer, wine
Sauerkraut, soy sauce, yeast, soups, pizza, MSG, some chocolates
What are some drugs to avoid when taking MAOI's
Asthma meds
Sinus meds
Narcotics *Demerol
Name some SSRI drugs
prozac, luvox, paxil, zoloft, lexapro
What are some side effects of SSRI's
anxiety, agitation, akathisia, nausea, insomnia, and sexual dysfunction, specifically diminished sexual drive or difficulty achieving an erection or orgasm less common is sweating and continued sedation
Name some mood stabilizing drugs
anticonvulsants such as Tegretol and Depakote, Depakene, Neurontin and Lamictal Klonopin
What are mood stabilizing drugs used for
they are used to treat bipolar affective disorder by stabilizing the clients highs and lows
What is involved in the pre-lithium work up
thyroid, renal and cbc, lytes & chem panel
Lithium dosage and toxicity level
usually given in 1-3 300 mg doses per day it takes up to 2 wks to have an effect on mood
*Small therapeutic window of 0.5-1.5
Signs of lithium toxicity
severe diarrhea, vomiting, drowsiness, muscle weakness, and lack of coordination; can lead to renal failure, coma & death
What are some common side effects of lithium
mild nausea or diarrhea, anorexia, fine hand tremor, polydipsia, polyuria, and a metallic taste in the mouth and fatigue or lethargy
What are some antianxiety drugs
Xanax, librium, klonopin, tranxene, valium, dalmane, ativan, serax, restoril, halcion
What are antianxiety drugs used for
used to treat anxiety and anxiety disorders, insomnia, OCD, depression, post-traumatic stress disorder, and alcohol withdrawl