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80 Cards in this Set
- Front
- Back
Axis 1
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Psychiatric Disorders
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Axis 2
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Personality disorders
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Axis 3
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Medical Conditions
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Axis 4
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Psychosocial stressors (1-6)
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Axis 5
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Global assessment of functioning score (GAF)
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What are some components of the Mental Status Exam?
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General appearance/attitude.
Behavior Cognitive functioning. Thought process, content and perception. |
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What is mood?
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An emotion that determines an individual's view of the world.
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What are the 5 levels of mood?
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Depression
Dysthymia (Low grade depression) Euthymia Hypomania Mania |
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What is affect and how is it determined?
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Assesses the patients emotional responsiveness, determined by patient's facial expressions and tone of voice.
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What are the four levels of affect?
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Flat
Blunted Constricted Normal Range |
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What are Thought Content problems (name 4 of them)
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1.Delusions
2.Obsessions 3.Ideas of reference 4.Ideas of influence |
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Describe delusions
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Fixed, false beliefs, can be grandiose, paranoid or somatic
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Describe obsessions
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Unwanted thoughts
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Describe ideas of reference
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Believe object is talking to them
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Describe ideas of influence
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Higher force is causing something.
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Describe a CIRCUMSTANTIAL thought process
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Lack of a clear thought direction due to unnecessary extra information, but individual eventually returns to original thought.)
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Describe a TANGENTIAL thought process.
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Thread of conversation is lost, and the individual is pursuing other thoughts (does not return to original thought)
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Describe a word salad thought process
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Incoherent connections or thoughts
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What is a neologism?
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New word
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Describe two types of perception disturbances
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Hallucinations
Illusions |
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Describe hallucinations
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Auditory (schizo), visual/tactile (drugs), olfactory, gustatory. THING THEY SEE IS NOT ACTUALLY THERE
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Describe Illusions
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Visual misinterpretation of visual stimuli (something ACTUALLY there)
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What is orientation?
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Person's ability to know who they are, where they are and what date/time it is.
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What is sensorium?
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Refers to alertness of patient
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What is Judgement?
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Patient's ability to understand the outcome of their behavior.
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What is Insight?
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Patient's degree of awareness that they are ill. Often impaired when psychotic, may lead to non-compliance.
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What is a Histrionic patient?
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Seductive
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What are narcissistic patients?
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Know more than you do, or so they think
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Describe some general techniques for dealing with these nut cases
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Establish rapport early.
Open ended questions (unless paranoid/schizo) Don't touch. Set limits. Don't stare. |
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When it is important to obtain collateral sources?
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If patient has impaired insight or patient requires a high degree of assistance.
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Which typically has a faster onset, psychiatric illness or medical illness?
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Medical is faster.
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What are the typical ages of medical conditions versus psychiatric conditions?
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Medical >40 yo
Psychiatric <40 yo |
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Who can perform psychotherapy?
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Psychologists, Psychiatrists or psychotherapists.
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What is the general procedures for psycho therapy?
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-Short term
-Patient's history normally acquired before therapy. |
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What is therapeutic alliance?
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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 |
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What is Transference?
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Passing on good or bad traits of someone on to therapist... can go both ways...
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Name some C/O to Psychotherapy
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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) 5.Countertransference |
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Describe Psychodynamic therapy
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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. MUST HAVE INSIGHT, MOTIVATION AND TOLERANCE FOR FRUSTRATION AND A JOB. |
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For what conditions is Cognitive therapy useful?
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Depression, bipolar, OCD
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Describe cognitive therapy
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Based around concept that there are errors in information processing in these patients. Maladaptive and distorted thoughts lead to maladaptive and distorted behavior.
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What is dichotamous thinking? What axis?
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Axis 1: Sith - one way or the other, black and white
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What is overgeneralizing? What axis?
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Axis 1: One instance taken as representative
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What is Mind reading? What axis?
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Axis 1: When other's attitudes are assumed
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"I am helpless" What axis?
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Axis 2: Dependent cognitive distortion
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"I might get hurt" What axis?
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Axis 2: Avoidant cognitive distortion
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"People are out to get me" What axis?
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Axis 2: Paranoid Cognitive Distortion
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"I am special" What axis?
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Axis 2: Narcissistic Cognitive distortion
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"I need to impress" What axis?
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Axis 2: Histrionic cognitive distortion
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"People are there to be taken" What axis?
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Axis 2: Antisocial cognitive distortion
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What are 3 cognitive techniques?
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1. Identify automatic thoughts.
2. Modify automatic thoughts. 3.Identifying and modifying schemas |
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Behavior therapy is most useful in what conditions?
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Anxiety
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Describe overall BT
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Patient develops new and adaptive ways of behaving through changing the environment that produces the behavior.
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What is Systemic Desensitization?
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BT that is not common, a phobia treatment
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What is Exposure Therapy?
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BT that conissts of implosion and flooding. Used commonly for treatment of phobias. Toss them right in.
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What is Reinforcement?
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BT that is used in children/adolescents with conduct or eating disorders.
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What is Extinction?
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BT technique that removes positive reinforcement, may lead to increase in unwanted behavior briefly
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What is Aversion therapy?
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BT technique where patient may experience a bad situation when they perform unwanted behavior
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What is relaxation therapy?
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BT used as part of many therapies. Teaches patients to tense and then relax groups of muscles.
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What is modeling?
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BT where the therapist performs the desired behavior and the patient then performs the same function.
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What is Social Skills training?
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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)
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CBT is useful in what Dz states?
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D
Bi GAD PD OCD B Phobias |
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Describe Crisis intervention information
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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. |
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What is Group Psychotherapy?
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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.
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Describe the Sex risk factor for suicide
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Women attempt more, men succeed
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Describe the age risk factor for suicide.
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Older increased risk, young attempt more
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Describe Race risk factor for suicide.
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Whites more
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Describe Religion risk factor for suicide
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Jews/Protestants much more than catholics
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Describe marital status risk factor for suicide
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Single, divorced, separated, widowed have increased risk.
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Describe occupation risk factor for suicide
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Job decreases risk
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Describe Methods risk factor for suicide
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Owning a gun increases
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Describe climate risk factor for suicide
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No effect
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Describe Physical Health risk factor for suicide
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Chronic conditions (i.e. MS, AIDs CVD...) increase risk. Loss of mobility, disfigurement and chronic pain are factors strongly associated.
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When is the suicide risk highest for admitted patients?
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During the 1st week
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Describe why ADs tend to have a risk factor for depression
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Due to the sequence of symptomatic improvement, Increased energy but not mood, so now they may do it.
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Describe Symptoms that may serve as precursors to emerging suicidality in AD users
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New onset agression, irritability, akathisia, anxiety, hostility, hypomania, mania
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4 Protective factors for suicide
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1. Social support
2. Pregnancy 3. Parenthood 4. Religion |
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Describe factors that would lead to inpatient treatment of attempted suicide
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Absence of social suppport.
Impulsive behavior. Suicidal plan of action. Unable to contract for safety |
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Describe factors that would lead to outpatient treatment of attempted suicide
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Presence of strong social support system. Lacks a h/o of impulsive behavior, able to contract for safety.
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What drug has indication for recurrent suicidal attempt?
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Clozapipne
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What drugs to avoid in suicide risk patients?
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TCAs and MAOi's
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