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215 Cards in this Set
- Front
- Back
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what are the most prevalent mental illnesses
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schizophrenia and mood disorders
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what is the onset of schizophrenia
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Males: late adolescence – early 20’s
Females: early – mid 20’s |
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what is the criteria for schizophrenia diagnosis
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2 or more of the following present for 1 month
Delusions Hallucinations Disorganized speech Grossly disorganized or catatonic behavior Negative symptoms Social/Occupational Dysfunction For a significant portion of time since the onset of the disturbance, one or more of the following are markedly below the level achieved prior to onset Work functioning Interpersonal relations Self-careDuration Continuous signs of the disturbance persist for at least 6 months Must include at least 1 month of active-phase symptoms Schizoaffective and Mood Disorder Exclusion Substance/General Medical Condition Exclusion Relationship to Pervasive Developmental Disorder |
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what are delusions
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A fixed, false belief
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what are hallucinations
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False sensory perceptions
Tactile, olfactory, auditory, visual, gustatory |
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what are illusions
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Misinterpretation of actual events
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what is paranoid type schizophrenia
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Preoccupation with one or more delusions OR frequent auditory hallucinations
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what is not prominent in paranoid type schizophrenia
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Disorganized speech
Disorganized or Catatonic Behavior Flat or inappropriate affect |
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what is disorganized schizophrenia
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All of the following are prominent:
Disorganized Speech Disorganized behavior Flat or inappropriate affect The criteria for Catatonic type are not met |
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what is catatonic type schizophrenia
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A type of Schizophrenia in which the clinical picture is dominated by at least two of the following:
Motoric immobility as evidenced by catalepsy or stupor Excessive motor activity (purposeless and not influenced by external stimuli) Extreme negativism or mutism Peculiarities of voluntary movement as evidenced by posturing, stereotyped movements, prominent mannerisms, or prominent grimacing Echolalia or Echopraxia |
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what is undifferentiated type schizophrenia
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Symptoms of Criterion A are met but criteria are not met for Paranoid, Disorganized, or Catatonic Type
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what is residual type schizophrenia
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Absence of prominent delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior
There is continuing evidence of the disturbance as evidenced by the presence of negative symptoms or 2 or more symptoms of Criterion A but in a less severe form (ex. odd beliefs) |
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what are the phases of schizophrenia
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prodromal, acute, recovery
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what is the prodromal phase
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May have acute or slow onset
Patient has change in behavior May be unusually preoccupied Social withdrawal common Problems at work or school |
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what is the acute phase
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Overt symptoms are observed
Psychotic episode. Can have positive or negative symptoms |
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what are positive symptoms
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Delusions, hallucinations, illusions, catatonia
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what are negative symptoms
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Alogia, anhedonia, avolition
Flat or blunted affect |
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what is the recovery phase
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Symptoms subside or improve with treatment
Patient learns to cope with symptoms Improvement of functioning Relapses common Depression or anxiety may develop |
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what is the genetic theory to the cause of schizophrenia
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Structural brain changes observed on CT scans
Lead to neurological and developmental alterations Genetic predisposition within families First degree relatives 10% chance Identical twins 50% chance Increased risk if mothers have influenza during second trimester |
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who developed the psychodynamic theory
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freud and bleuler
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what is the psychodynamic theory to the cause of schizophrenia
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Belief that Schizophrenia develops due to poor caregiving provided to child
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what is the neurobiological theory to the cause of schizophrenia
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Changes occur within 5 system areas of the brain
3 Anatomic Systems Prefrontal, limbic, basal ganglia 2 Functional Systems Language and Memory |
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what is the dopamine theory to the cause of schizophrenia
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An overproduction of dopamine in limbic area and prefrontal cortex area of the brain
Excess dopamine is responsible for delusions and hallucinations |
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what is the substance abuse theory to the cause of schizophrenia
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Person’s use of drugs or alcohol cause physical and psychological changes that predispose to development of Schizophrenia
Not enough research on this theory |
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what is the Diathesis Stress Theory to the cause of schizophrenia
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Development of Schizophrenia due to many factors
Genetics, environment, anatomic and functional systems, and the contribution of stressors Changes in these systems in addition to stressors predisposes to the disease |
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what is psychosis
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A person’s symptom state that refers to the presence of reality misperceptions, disorganized thinking, and lack of awareness of true and false reality
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what is psychosis due to
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May be due to medical, neurological, or psychiatric condition, or use of substances
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what are hallucinations
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Distorted perceptions of reality
May involve one or all 5 senses May or may not be able to observe a patient experiencing hallucinations |
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what should you do with a patient with hallucinations
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Gently discuss with patient about nature of hallucinations
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what are somatic delusions
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false belief regarding body
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what are nihilistic delusions
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believe world is ending or they are dying
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what are persecutory delusions
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believe they are threatened or spied on
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what are religious delusions
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having special religious powers
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what are sexual delusions
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others know about sexual activity and that activity causes illness
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what are ideas of reference delusions
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insignificant remarks/activities have special meaning to them
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what is thought broadcasting
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belief others can see their thoughts
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what is though inserction
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belief others put thoughts in their mind
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what is thought withdraw
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belief others take thoughts out of their mind
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what is mind reading
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belief others can read their mind or they can read other’s minds
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what do you do if a patient is extremely delusional
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best not to correct delusions
Patient may become angry, upset – limits rapport |
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what do illusions occur with
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Occur with delusions and hallucinations
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what is schizoaffective disorder
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An uninterrupted period of illness during which at some time there was either a major depressive episode, a manic episode, or a mixed episode concurrent with symptoms that meet criterion A of schizophrenia
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what are the types of schizoaffective disorder
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Bipolar or Depressed
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what is delusional disorder
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Nonbizarre delusions of at least 1 month’s duration
Criterion A for Schizophrenia never met Overall functioning not impaired; no bizarre behaviors |
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Disturbance in mood is primarily what
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Disturbance in mood is primary diagnostic and symptom factor
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what are the types of mood disorders
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Major Depressive Disorder
Dysthymic Disorder Bipolar Disorder |
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what are the issues with children and psychotic
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Sometimes diagnosis is difficult due to children’s varied developmental stages
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what are issues to consider when developing a diagnosis for children with psychotic disorders
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Normal/abnormal behaviors
Length, type, and occurrence of symptoms Social interactions Length of abnormal behaviors |
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what other factors must be considered with children
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Must consider other factors such as trauma, physical illness, mental retardation, learning disabilities, and parental illness
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how do you get a correct diagnosis with children
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Complete, thorough assessment
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what are interventions for children with psychotic disorders
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Involve school, home, and social settings
Psychotherapy Psychoeducation Play therapy |
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how is autism correlated with schizophrenia
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Some children diagnosed with autism at an early age later develop schizophrenia
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what is autism
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Abnormal/impaired development in social skills
Severely restricted activity and interests Socially isolated Emotionally aloof; uncommunicative |
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what are the difference between autism and schizophrenia
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Autism is diagnosed at early age and there are evident global dysfunctional patterns
Autism increases risk for mental retardation Onset of schizophrenia occurs in adolescence and adulthood |
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what do many psychiatric symptoms mimic
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Many psychiatric symptoms mimic normal adolescent patterns of behavior
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what is noticed in adolescent psychiatric disorders
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more pronounced symptoms
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what is the recovery prospect for adults with psychotic disorders
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Psychotherapy
Medication Community based services Support systems Education |
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what are the main types of meds for psychotic disorders
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typical and atypical psychotics
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what do antipsychotics affect
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Affect anatomic and functional brain systems
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what do typical antipsychotics do
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DA antagonists
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what do atypical antipsychotics do
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DA antagonists and 5HT receptor blockers
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what is the half life of psychotics
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Many have >12 hours
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what do antipsychotics do
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Decrease delusions, hallucinations, illusions
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what are the problems with typicals
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High level of side effects
Extrapyramidal side effects (EPS) Tardive Dyskinesia |
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what are extrapyramidal side effects
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Muscle stiffness, tremors, akathesia
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what is tardive dyskinesia
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Irreversible
Lip smacking, tongue rolling, grimaces, jerking movements of extremities |
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what are some typical antipsychotics
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Haldol, Prolixin
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why do atypicals have less side effects
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more receptor specific
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what are side effects of atypicals
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Side effects of increased appetite (weight gain), sedation, EPS, hyperprolactinemia
More serious: diabetes, high lipids, cardiovascular |
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what are some common atypicals
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Zyprexa, Risperdal, Abilify, Clozaril
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what is Neuroleptic Malignant Syndrome attributed too
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neuroleptic medications
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what is neuroleptic malignant syndrome
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Serious and potentially lethal
Generalized rigidity, mental status changes Hyperthermia, tremors, tachycardia |
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what is the treatment for neuroleptic malignant syndrome
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stop neuroleptic medication, care for symptoms
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what does psychotherapy and psychoeducation do
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Helps patients understand their illness
Helps in learning and using coping skills As patients adjust to their illness and gain insight, therapist provides guidance and support |
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what are common psychotherapies for schizophrenia
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Supportive Therapy
Cognitive Behavioral Therapy |
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what is social skills education
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Aids patients in understanding appropriate social interactions within the presence of symptoms
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what is Psychosocial rehabilitation necessary for
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patients to gain independence during recovery
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what is vocational rehabilitation do
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aids in learning and implementing career skills
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what is Stress and Crisis Management Education
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Patients need to know how to cope with symptom exacerbation to prevent relapse
Stress increases frequency and severity of symptoms Medication and treatment compliance necessary to help avoid relapse Support systems important |
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what does a generalist nurse do for psychotic disorders
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Develops and implements initial treatment plan
Monitors patient’s progress Involved in psychoeducation |
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what do Advanced Practice Psychiatric Nurses do
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Coordinates patient’s care
Provides psychotherapy (individual, group and family) May develop and conduct research studies May have prescriptive authority Uses in-depth nursing process |
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what is personality defined as
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characteristic traits that are generally predictable and influence one’s thinking, emotions and behavioral patterns
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how do personality characteristics develop
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These characteristics develop over time, may be conscious or unconscious and affect adaptation and responses over time.
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what are personality traits
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are how we perceive, relate to and think about our environment.
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when do personality traits constitute a personality disorder
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It’s only when these traits cause significant functional impairment (social, interpersonal, vocational) they they constitute a personality disorder.
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what is adaption
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Is the ability to mobilize resources to adjust to the internal and external demands
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how does personality influence adaption
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Personality traits influences whether this adaptation will be healthy or maladaptive
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what do maladaptive responses do
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increase internal stress and are a key component in personality disorders
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what is a personality disorder
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Long-standing, pervasive, maladaptive patterns of behavior and relating to others
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what is the onset of personality disorders
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in adolescence or early adulthood
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what do personality disorders lead to
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Leads to distress or impairment in functioning
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what is the DSM criteria for personality disorders
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Enduring pattern of inner experience and behavior that deviates from the expectations from culture manifested in the following 2 areas:
1. Cognition (ways of perceiving and interpreting self, other people, and events) 2. Affectivity (the range, intensity, lability, and appropriateness of emotional response) 3. Interpersonal functioning 4. Impulse control |
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what is an enduring pattern
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- inflexible and pervasive across a broad range of personal and social situations
- distress or impairment in social, occupational, or other important areas of functioning - onset can be traced back at least to adolescence or early adulthood - not better accounted for as a manifestation or consequence of another mental disorder - not due to the direct physiological effects of a substance or a general medical condition |
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what are the types of personality disorders
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Obsessive-Compulsive PD: 7.9%
Paranoid PD: 4.4% Antisocial PD: 3.6% Schizoid PD: 3.1% Avoidant PD: 2.4% Histrionic PD: 1.8% Dependent PD: 0.5% |
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what are the theories for personality disorders
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Psychodynamic
Neurobiological Genetics Environmental |
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what influences the development of a personality disorder
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Biologic predisposition along with psychological and environmental factors influences the development of a [personality disorder.
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what is the psychodynamic theory
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Healthy ego function is influenced by:
Relationships with early childhood providers influences later interactions Trust that needs would be meet Mastery of self and environment Predictability |
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what did freud say personality development was from
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Personality development via the psychosexual stages of oral, anal and genital (oedipal).
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how did erickson say the personality develop
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Stages of development
Trust vs. Mistrust Autonomy vs. Shame and Doubt |
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what theory did clein, kronberg, and mahler have
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Object relations theory
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what is the Bowlby- Attachment Theory
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Attachment behavior protects and assists in ego function
Attachment is a normal response in periods of need if this is not accomplished then ego function is impaired |
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what is the neurobiological symptoms of personality disorders
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Serotonin and dopamine dysregulation can influence impulsivity, anger and mood instability
Low monoamine oxidase levels Alterations in EEG voltage in temporal and parietal lobes |
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Monamine oxidase is necessary for what
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metabolism of dopamine
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what is seen in Neuroimaging in Personality Disorders
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Structural Imaging
decreased prefrontal grey matter decreased hippocampal volume. Functional Studies Reduced perfusion in frontal and temporal lobes |
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what is the genetic theory for personality disorders
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Links to certain personality traits
Monozygotic twin studies higher incidence of personality disorder Schizotypal personality disorder has same genetic predisposition as for schizophrenia |
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what are environmental theories for personality disorders
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Trauma
Lack of connection to others Family dynamics Impaired relationships with others Abuse or neglect LSES |
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how are personality disorders divided
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3 clusters:
- Cluster A - Cluster B - Cluster C |
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what are the types of cluster A PD
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Paranoid
Schizoid Schizotypa |
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how are cluster A PD described
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Described as the odd and eccentric cluster
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diagnosis or cluster A PD are more likely to be prevalent with what
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an axis I psychotic disorder
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what are cluster B personality disorders
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Antisocial
Borderline Histrionic Narcissistic |
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what are cluster B PD described as
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Described as the dramatic and emotional cluster
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Cluster B PD diagnoses are more likely to be with what
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an Axis I affective disorder
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what are cluster C PD
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Avoidant
Dependent Obsessive-compulsive |
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How are Cluster C PD described
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Described as the anxious and fearful cluster
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Cluster C PD diagnoses are likely to be with what
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an Axis I anxiety disorder
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what is paranoid personality disorder
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Individuals with this d/o are suspicious and mistrustful
Believe that others are plotting harm or talking about them behind their backs |
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what is difficult for patients with paranoid PD
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Forming intimate relationships is difficult for them because they are so “on guard” and fear that others will hurt them
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what happens with patients with paranoid PD
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Sometimes individuals with this d/o are aloof and removed, whereas others are angry and aggressive
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what happens in patients with schizoid personality disorders
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Isolative
Lack social and close relationships and have difficulty relating to others, including being part of a family If they work, they hold jobs that require little or no contact with others Loners, show little emotion, and are indifferent to praise or criticism Take pleasure in few activities Appear to be emotionally cold or flat |
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what are the characteristics of schizotypal personality disorders
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Characterized by odd and peculiar speech, thoughts, and behaviors
May believe they can predict the future, dress oddly, or laugh when discussing serious matters |
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what are symptoms of schizotypal pd
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Suspicious, lack friends, and display inappropriate affect
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how do behaviors appear in schizotypal personality disorders
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Behavior appears eccentric and out of the ordinary
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how do schizotypal patients display behavior
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Display behaviors that seem like a milder, non psychotic state of schizophrenia
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what is antisocial personality disorder
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Long-standing pattern of lack of concern for and violation of the rights of others
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what do patients with antisocial PD display
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socially irresponsible behaviors—lying, stealing, fighting, disregard for safety of others
No remorse or guilt over the harm or pain caused Failure to take responsibility for their actions Initial charm dissolves to coldness, manipulation, blaming others |
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what happens in children with antisocial PD
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As children, they often displayed conduct problems—truancy, assaults, cruelty to animals, fire setting, SA
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Antisocial PD has a tendency to accompany what
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criminal behavior
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what is borderline personality disorder characterized by
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Characterized by unstable and intense interpersonal relationships
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what is the hallmark of borderline PD
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The hallmark is manipulative, needy, demanding, and angry behavior
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what happens in relationships in people with borderline pd
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Unable to form secure relationships with others and frantically avoid real or imagined loss or abandonment
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what is display splitting
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the fluctuation of good and bad views of the world and relationships
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people with borderline PD usually engage in what
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impulsive acts—binging, spending money, reckless driving, unsafe sex
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what can the patients do with borderline PD
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Repeated suicidal threats and actions emerge
Self-mutilation/SIB |
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what is histrionic PD
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Attention-seeking; self-centered attitudes
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how do histrionic PD patients draw attention to themselves
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Draw notice to themselves through their dramatic speech, flamboyant dress, or sexually provocative behaviors
Consistently uses physical appearance to draw attention to self |
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what pervades all relationships and all situations for patients with histrionic PD
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Their flair for the dramatic
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what do patients with histrionic PD display
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rapidly shifting and shallow expression of emotions
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what do histrionic PD patients complain of
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physical illness, somatization
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what is narcissistic PD
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This disorder consists of an extreme sense of arrogance, entitlement, and self-importance—grandiose
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what is seen in narcissistic patients
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Lacks empathy toward others
Need attention and admiration Take advantage of others Preoccupied with fantasies of success, brilliance, beauty, and ideal love |
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what is malignant narcissism
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narcissism and criminality: narcissism with antisocial + paranoid traits
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what is seen in malignant narcissism
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Self-importance, “specialness”
Entitlement, exploitation of others Lack of empathy, remorse. Takes pleasure in aggression, sadism, suffering of victims. (“depraved indifference” in terms of criminal law) |
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who is seen to have malignant narcissism
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serial killers
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what is avoidant PD
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Fearful of rejection, criticism, and disapproval
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what is seen in avoidant PD
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Avoids social interactions—but would like to participate
Hypersensitive Negative sense of self; low self-esteem |
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what is dependent pd
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Show an over reliance on others for support, reassurance, and love
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what is seen in patients with dependent PD
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Unable to make decisions independently
Low self-esteem and self-doubt are common Tend to agree with others rather than state a different opinion for fear of losing that relationship |
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what is Obsessive compulsive PD
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Preoccupation with perfection, organization, structure, and control
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what is seen in OCPD
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Extreme rigidity and control are the hallmark of this d/o
Preoccupied with trivial details Inability to discard anything Difficulty relaxing Reluctance to spend money Insistence that others’ conform to their own methods Self-criticism and inability to forgive own errors |
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what are treatments for PD
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Multidisciplinary team
Individual and groups CBT and DBT Psychopharmacology is aimed at symptom management |
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what are nursing diagnosis for patients with PD
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Risk of suicide
- chronic low self-esteem - disturbed thought process - impaired social interaction - risk for self-mutilation - powerlessness - ineffective coping - defensive coping - anxiety - disturbed personal identity - violence, risk for: self-directed or directed at others |
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what are nursing interventions for PD
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Nurse will be most helpful when able to determine the specific needs of the client with each contact
Contact is client centered Contact is time oriented (make every minute count!) Boundaries are crucial |
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what are nursing interventions of cluster A PD
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Establish rapport
Support adaptive behavior Respect personal space Engage in structured groups Role model social interaction Education on atypical psychotropics |
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what is the nursing approach for cluster A PD
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non-threatening, calm manner.
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what are interventions for cluster B PD antisocial
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Early identification and interventions thru social support services
Teaching adaptive coping skills Be sensitive and non-judgmental Clear boundaries, expectations and communication |
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what are interventions for cluster B borderline
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Clear consistent boundaries
Develop rapport Verbalization of feelings and sense of self Assist in reducing destructive behaviors Adaptive coping mechanisms |
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what are the interventions for cluster C
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Clear consistent boundaries
Develop rapport Verbalization of feelings and sense of self Assist in reducing destructive behaviors Adaptive coping mechanisms |
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what are the boundaries for the nurse for PD
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Necessary to develop therapeutic alliance
Provide safety for you and client Allows client to put focus on self Permits more time for interpersonal interactions. |
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how do you set boundaries
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Clear of idea of rules and expectations
Follow through with these Consequences for violations Confront manipulative behavior Be aware of settings Do not see free of charge Begin and end session on time Clear financial arrangements Avoid accepting any gifts Small gifts may be accepted but do not display them No bartering or references Avoid discussing your personal life Do not make special arrangements |
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what is transference
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Transference is the unconscious displacement of feelings and attitudes from client to provider
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what is countertransference
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intense emotional reactions to the client from the provider
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what is the evaluation for PD
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Long term treatment
Monitor for regressive behaviors Appropriate management of emotions and behaviors Enhance Interactions |
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what are the types of somatoform disorders
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Somatization Disorder
Undifferentiated Somatoform Disorder Conversion Disorder Pain Disorder Hypochondriasis Body Dysmorphic Disorder (BDD) |
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what are somatization disorders
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History of many physical complaints beginning before age 30 and result in treatment being sought or significant impairment in social, occupational or other areas of functioning
No clinically significant organic etiology |
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what is the criteria for somatization disorders
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4 pain sx: a hx of pain r/t at least 4 different sites of function (head, back, abdomen, joints, extremities, chest, rectum, during menstruation, during sex, or during urination)
2 GI sx: nausea, bloating, vomiting, diarrhea, or intolerance to several different foods 1 sexual sx: sexual indifference, erectile or ejaculatory dysfunction, irregular menses, 1 pseudoneurological sx Conversion sx such as impaired coordination or balance, paralysis or localized weakness, difficulty swallowing or lump in the throat urinary retention, hallucinations, loss of touch or pain sensation, double vision, blindness, deafness, seizures Dissociative sx such as amnesia or loss of consciousness other than fainting |
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what is conversion disorder
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The term conversion comes from the idea that the individual uses the somatic sx in an unconscious manner to reduce or repress a psychological conflict that creates anxiety
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what is the most common symptom of conversion disorder
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is a disorder of movement—inability to walk, stand, or move an arm
Researchers have found that 71% of clients present with CNS sx |
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what are symptoms of conversion disorder
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blindness, deafness, or difficulty swallowing
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what is la belle indifference
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The client often seems unconcerned about this serious, sudden incapacitation
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what suggests suggests a neurological or other general medical condition in conversion disorder
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Clients exhibit 1 or more symptoms or deficits affecting voluntary motor or sensory function
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what is are judged to be associated with the sx or deficit in conversion disorder
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psychological factors
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how is the symptom or deficit produced in conversion disorder
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not intentionally produced
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the symptom or deficit in conversion disorder is not limited to what
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pain or sexual dysfunction
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what does the symptom or deficit in conversion disorder do
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impairs functioning or warrants medical evaluation
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what is motor symptoms or deficit in conversion disorder
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impaired coordination, balance, paralysis, localized weakness, difficulty swallowing, aphonia, urinary retention
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what is the sensory symptom or deficit in conversion disorder
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loss of touch, or pain sensation,double visions, blindness, deafness and hallucinations
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what is conversion disorder with sensory or convulsions
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includes seizures or convulsions with voluntary motor or sensory components
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what is conversion disorder with mixed presentation
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symptoms of more than one category are present
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what is pain disorder
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The predominant clinical focus is pain in one or more anatomic sites
The pain is of sufficient severity to warrant clinical attention and cause impairment in 1 or more areas of functioning |
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what is the role of psychological factors in pain disorder
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onset, severity, exacerbation, or maintenance of pain
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what is hypochondriasis
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Individual is preoccupied with fears of having—or the idea of having—a serious medical d/o based on the individual’s misinterpretation of bodily sx
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misinterpretation of symptoms persists in with what in hypochondriasis
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appropriate medical evaluation and reassurance
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what is body dysmorphic disorder
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Characterized by a preoccupation with an imagined defect in appearance
If the individual has a slight physical anomaly, the person’s concern is markedly excessive |
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what does body dysmorphic disorder cause
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causes clinically significant distress or impairment in social or occupational functioning
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what are the typical concerns focused on in body dysmorphic disorder
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imagined or minor flaws of the face or head—wrinkles, complexion tone, markings such as scars or freckles, excessive or thinning hair, or asymmetry of the face, eyes, ears, or nose
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what do patients with body dysmorphic disorder usually do
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spend inordinate amounts of time checking their “defect” in mirrors
Often extreme grooming rituals are present |
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what are dissociative disorders
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Is the breakdown of one’s perception of his/her surroundings, memory, identify or consciousness
Dream like state |
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dissociative disorders have a disturbance in what
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organization of identity, memory, perception or consciousness
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what are the types of dissociative disorders
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Dissociative Amnesia (psychogenic amnesia)
Dissociative Fugue (psychogenic fugue) Dissociative Identity Disorder (Multiple Personality Disorder) Depersonalization Disorder |
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what is dissociative amnesia
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Inability to recall important personal information, which is usually associated with a traumatic event
Memory loss creates gaps in an individuals personal history |
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what is dissociative fugue
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Impulsive wandering or travels after a traumatic event away from home
Appears to be functioning normally |
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what happens to the patient after the fugue
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the individual is unable to recall events during the fugue state
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what is dissociative identity disorder
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Two or more distinct identities or personalities
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what happens to people with dissociative identity disorder
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inability to recall personal information
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dissociative identity disorder is not associated with what
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substance abuse
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patients with dissociative identity disorder usually have past of what
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severe abuse/neglect
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what is depersonalization disorder
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Feelings of detachment or estrangement from one’s self.
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how is depersonalization disorder described
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living in a dream or outside of their body watching themselves
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depersonalization disorder does not occur with what
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under influence of substances or with an Axis I disorder
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what are the nursing interventions for dissociative disorders
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Supporting the client during the dissociation
Psychoeducation regarding disorder Provide safety and security Coping mechanisms to regulate affect and minimize disruption of the disorder |
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what are self injurious behaviors (SIB)
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Purposeful action that harms the body
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what should be assessed in SIB
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Not suicide attempts but did to be assessed closely for SI.
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what are risks for SIB
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Age- adolescents due to physical and emotional changes
Sexual abuse Neglect or emotional/physical abuse Impaired communication Untreated depression/anxiety Substance abuse |
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what are the most common forms of SIB
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Cutting
Burning Pinching Scratching Hitting Interfering with wound healing Trichotillomania |
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what are the common areas of SIB
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Arms and wrists
Legs Abdomen Head Chest Genitals |
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what is the neurobiologic theory for SIB
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dysregulation of serotonergic pathway; endorphin release
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what is the psychodynamic theory for SIB
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result of anger turned inward and is an emotional catharsis
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what is the rational for SIB
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Coping strategy
To decrease numbness Maintain contact with reality Distract from painful thoughts Sense of control Self-punishment Receiving support and care form others |
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what is cascade of emotions
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Event triggers negative thoughts
Exacerbates anxiety which leads to Dissociates and detach from bodies, environment and behavior |
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what does SIB produce
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(+) endorphins which counters the (-) emotions
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what is seen in cascade of emotions
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Rebound guilt, shame, punishment
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what are the outcomes for SIB
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Ability to identify and verbally express feelings
Use alternative behavioral techniques to self injury |
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what are the interventions for SIB
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Gentle, non-threatening questions
Assess feelings after self-injury Provide safe environment with structure, predictability and consistency Treat injuries in a non-judgmental manner Increase feelings awareness Coping skills with focus on managing feelings Avoidance of substance use Identification of self soothing techniques Behavioral alternative to self-injury |
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what does psychopharmacology do for PD patients
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Decreases anxiety to engage in therapy
Decreases cognitive distortions Prevent escalation of anxiety to panic Assist in processing trauma memories |
