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80 Cards in this Set

  • Front
  • Back
Axis 1
Psychiatric Disorders
Axis 2
Personality disorders
Axis 3
Medical Conditions
Axis 4
Psychosocial stressors (1-6)
Axis 5
Global assessment of functioning score (GAF)
What are some components of the Mental Status Exam?
General appearance/attitude.
Cognitive functioning.
Thought process, content and perception.
What is mood?
An emotion that determines an individual's view of the world.
What are the 5 levels of mood?
Dysthymia (Low grade depression)
What is affect and how is it determined?
Assesses the patients emotional responsiveness, determined by patient's facial expressions and tone of voice.
What are the four levels of affect?
Normal Range
What are Thought Content problems (name 4 of them)
3.Ideas of reference
4.Ideas of influence
Describe delusions
Fixed, false beliefs, can be grandiose, paranoid or somatic
Describe obsessions
Unwanted thoughts
Describe ideas of reference
Believe object is talking to them
Describe ideas of influence
Higher force is causing something.
Describe a CIRCUMSTANTIAL thought process
Lack of a clear thought direction due to unnecessary extra information, but individual eventually returns to original thought.)
Describe a TANGENTIAL thought process.
Thread of conversation is lost, and the individual is pursuing other thoughts (does not return to original thought)
Describe a word salad thought process
Incoherent connections or thoughts
What is a neologism?
New word
Describe two types of perception disturbances
Describe hallucinations
Auditory (schizo), visual/tactile (drugs), olfactory, gustatory. THING THEY SEE IS NOT ACTUALLY THERE
Describe Illusions
Visual misinterpretation of visual stimuli (something ACTUALLY there)
What is orientation?
Person's ability to know who they are, where they are and what date/time it is.
What is sensorium?
Refers to alertness of patient
What is Judgement?
Patient's ability to understand the outcome of their behavior.
What is Insight?
Patient's degree of awareness that they are ill. Often impaired when psychotic, may lead to non-compliance.
What is a Histrionic patient?
What are narcissistic patients?
Know more than you do, or so they think
Describe some general techniques for dealing with these nut cases
Establish rapport early.
Open ended questions (unless paranoid/schizo)
Don't touch.
Set limits.
Don't stare.
When it is important to obtain collateral sources?
If patient has impaired insight or patient requires a high degree of assistance.
Which typically has a faster onset, psychiatric illness or medical illness?
Medical is faster.
What are the typical ages of medical conditions versus psychiatric conditions?
Medical >40 yo
Psychiatric <40 yo
Who can perform psychotherapy?
Psychologists, Psychiatrists or psychotherapists.
What is the general procedures for psycho therapy?
-Short term
-Patient's history normally acquired before therapy.
What is therapeutic alliance?
1.Work together to establish goals of therapy.
2.Adjust therapist activity level to match the severity of the illness/phase of treatment.
3.Encourage self-help/monitoring
4.Recognized and manage transference
What is Transference?
Passing on good or bad traits of someone on to therapist... can go both ways...
Name some C/O to Psychotherapy
1. Sadists, seriously violent (just kill 'em)
2.Total lack of remorse (assholes)
3.Superior intelligence or retards.
4.Inability to attach to others (historically)
Describe Psychodynamic therapy
Discuss unconcious or unclear material with therapist. Patient develops understanding as to why problems exist and how to avoid.
Improves self-understanding and ego strength.
For what conditions is Cognitive therapy useful?
Depression, bipolar, OCD
Describe cognitive therapy
Based around concept that there are errors in information processing in these patients. Maladaptive and distorted thoughts lead to maladaptive and distorted behavior.
What is dichotamous thinking? What axis?
Axis 1: Sith - one way or the other, black and white
What is overgeneralizing? What axis?
Axis 1: One instance taken as representative
What is Mind reading? What axis?
Axis 1: When other's attitudes are assumed
"I am helpless" What axis?
Axis 2: Dependent cognitive distortion
"I might get hurt" What axis?
Axis 2: Avoidant cognitive distortion
"People are out to get me" What axis?
Axis 2: Paranoid Cognitive Distortion
"I am special" What axis?
Axis 2: Narcissistic Cognitive distortion
"I need to impress" What axis?
Axis 2: Histrionic cognitive distortion
"People are there to be taken" What axis?
Axis 2: Antisocial cognitive distortion
What are 3 cognitive techniques?
1. Identify automatic thoughts.
2. Modify automatic thoughts.
3.Identifying and modifying schemas
Behavior therapy is most useful in what conditions?
Describe overall BT
Patient develops new and adaptive ways of behaving through changing the environment that produces the behavior.
What is Systemic Desensitization?
BT that is not common, a phobia treatment
What is Exposure Therapy?
BT that conissts of implosion and flooding. Used commonly for treatment of phobias. Toss them right in.
What is Reinforcement?
BT that is used in children/adolescents with conduct or eating disorders.
What is Extinction?
BT technique that removes positive reinforcement, may lead to increase in unwanted behavior briefly
What is Aversion therapy?
BT technique where patient may experience a bad situation when they perform unwanted behavior
What is relaxation therapy?
BT used as part of many therapies. Teaches patients to tense and then relax groups of muscles.
What is modeling?
BT where the therapist performs the desired behavior and the patient then performs the same function.
What is Social Skills training?
BT that helps patients overcome social deficits. Particular deficit is first identified then more appropriate behavior is developed through modeling and /or positive reinforcement. (Schizo/autism works well)
CBT is useful in what Dz states?
Describe Crisis intervention information
Developed as a structured intervention meant to decrease risk of PTSD following overwhelming experiences.
Debriefing can be done individually or as a group.
Try to begin within 72 hours of event.
May be series of sessions.
CAUTION in recommendation. Newer shit.
What is Group Psychotherapy?
Allows opportunities for modeling behaviors and motivating patients. Researchers in the field believe groups tend to act as if certain basic assumptions are true: Dependency group, Fight/Flight group, pairing group.
Describe the Sex risk factor for suicide
Women attempt more, men succeed
Describe the age risk factor for suicide.
Older increased risk, young attempt more
Describe Race risk factor for suicide.
Whites more
Describe Religion risk factor for suicide
Jews/Protestants much more than catholics
Describe marital status risk factor for suicide
Single, divorced, separated, widowed have increased risk.
Describe occupation risk factor for suicide
Job decreases risk
Describe Methods risk factor for suicide
Owning a gun increases
Describe climate risk factor for suicide
No effect
Describe Physical Health risk factor for suicide
Chronic conditions (i.e. MS, AIDs CVD...) increase risk. Loss of mobility, disfigurement and chronic pain are factors strongly associated.
When is the suicide risk highest for admitted patients?
During the 1st week
Describe why ADs tend to have a risk factor for depression
Due to the sequence of symptomatic improvement, Increased energy but not mood, so now they may do it.
Describe Symptoms that may serve as precursors to emerging suicidality in AD users
New onset agression, irritability, akathisia, anxiety, hostility, hypomania, mania
4 Protective factors for suicide
1. Social support
2. Pregnancy
3. Parenthood
4. Religion
Describe factors that would lead to inpatient treatment of attempted suicide
Absence of social suppport.
Impulsive behavior.
Suicidal plan of action.
Unable to contract for safety
Describe factors that would lead to outpatient treatment of attempted suicide
Presence of strong social support system. Lacks a h/o of impulsive behavior, able to contract for safety.
What drug has indication for recurrent suicidal attempt?
What drugs to avoid in suicide risk patients?
TCAs and MAOi's