NCM 117- CHAP1, 2, & 6

Mild anxiety

(Anxiety Levels) a positive state of heightened awareness and sharpened senses, allowing the person to learn new behaviors and solve problems. The person can take in all available stimuli (perceptual field).

Panic anxiety

(Anxiety Levels) can involve loss of rational thought, delusions, hallucinations, and complete physical immobility and muteness. The person may bolt and run aimlessly, often exposing him or herself to injury.

Moderate anxiety

(Anxiety Levels) involves a decreased perceptual field (focus on immediate task only); the person can learn new behavior or solve problems only with assistance. Another person can redirect the person to the task.

Severe anxiety

(Anxiety Levels) involves feelings of dread or terror. The person cannot be redirected to a task; he or she focuses only on scattered details and has physiologic symptoms of tachycardia, diaphoresis, and chest pain. A person with severe anxiety may go to an emergency department, believing he or she is having a heart attack.

identification phase

(Peplau's Stages and Tasks of Relationships) begins when the client works interdependently with the nurse, expresses feelings, and begins to feel stronger.

orientation phase

(Peplau's Stages and Tasks of Relationships) is directed by the nurse and involves engaging the client in treatment, providing explanations and information, and answering questions.

exploitation phase

(Peplau's Stages and Tasks of Relationships) the client makes full use of the services offered.

resolution phase,

(Peplau's Stages and Tasks of Relationships) the client no longer needs professional services and gives up dependent behavior. The relationship ends.

Concrete operations (6 to 12 years)

(Piaget's four stages of cognitive development) The child begins to apply logic to thinking, understands spatiality and reversibility, and is increasingly social and able to apply rules; however, thinking is still concrete.

Sensorimotor (birth-2 years)

(Piaget's four stages of cognitive development) The child develops a sense of self as separate from the environment and the concept of object permanence, that is, tangible objects do not cease to exist just because they are out of sight. He or she begins to form mental images.

Preoperational (2 to 6 years)

(Piaget's four stages of cognitive development) The child develops the ability to express self with language, understands the meaning of symbolic gestures, and begins to classify objects.

Formal operations (12 to 15 years)

(Piaget's four stages of cognitive development) The child learns to think and reason in abstract terms, further develops logical thinking and reasoning, and achieves cognitive maturity.

Leader

(Roles of the Nurses in the Therapeutic Relationship) offering direction to the client or group

Stranger

(Roles of the Nurses in the Therapeutic Relationship) offering the client the same acceptance and courtesy that the nurse would to any stranger

Counselor

(Roles of the Nurses in the Therapeutic Relationship) promoting experiences leading to health for the client, such as expression of feelings

Surrogate

(Roles of the Nurses in the Therapeutic Relationship) serving as a substitute for another, such as a parent or sibling

Teacher

(Roles of the Nurses in the Therapeutic Relationship) —helping the client learn either formally or informally

Resource person

(Roles of the Nurses in the Therapeutic Relationship) providing specific answers to questions within a larger context

psychotropic drugs

A great leap in the treatment of mental illness began in about 1950 with the development of ________ drugs used to treat mental illness.

frontal lobes

Abnormalities in this lobe are associated with schizophrenia, attention-deficit/hyperactivity disorder (ADHD), and dementia.

pons

Above the medulla and in front of the cerebrum, the ______ bridges the gap both structurally and functionally, serving as a primary motor pathway.

health

According to WHO, ____ is a a state of complete physical, mental, and social wellness, not merely the absence of disease or infirmity.

revolving door effect

Although people with severe and persistent mental illness have shorter hospital stays, they are admitted to hospitals more frequently.

serotonin syndrome

An uncommon but potentially serious drug interaction called ____________ can result from taking an MAOI and an SSRI at the same time. It can also occur if the client takes one of these drugs too close to the end of therapy with the other. In other words, one drug must clear the person's system before initiation of therapy with the other.

free association,

Another method used to gain access to subconscious thoughts and feelings is __________, in which the therapist tries to uncover the client's true thoughts and feelings by saying a word and asking the client to respond quickly with the first thing that comes to mind.

1. Tricyclic and the related cyclic antidepressants 2. Selective serotonin reuptake inhibitors (SSRIs) 3. MAO inhibitors (MAOIs) 4. Other antidepressants such as desvenlafaxine (Pristiq), venlafaxine (Effexor), bupropion (Wellbutrin), duloxetine (Cymbalta), trazodone (Desyrel), and nefazodone (Serzone)

Antidepressants are divided into four groups:

blood prolactin levels; prolactin

Antipsychotic drugs also increase ________ Elevated _______ may cause breast enlargement and tenderness in men and women; diminished libido, erectile and orgasmic dysfunction, and menstrual irregularities; and increased risk for breast cancer.

dopamine.

Antipsychotic drugs work by blocking receptors of the neurotransmitter

neurotransmission

Approximately 100 billion brain cells form groups of neurons, or nerve cells, that are arranged in networks. These neurons communicate information with one another by sending electrochemical messages from neuron to neuron, a process called _________

off-label use.

At times, a drug will prove effective for a disease that differs from the one involved in original testing and FDA approval.

Ivan Pavlov: Classical Conditioning

Behavior can be changed through conditioning with external or environmental conditions or stimuli. His experiment with dogs involved his observation that dogs naturally began to salivate (response) when they saw or smelled food (stimulus).

Behavioral Theories

Behaviorism grew out of a reaction to introspection models that focused on the contents and operations of the mind.

Norepinephrine (noradrenaline) ; Excitatory

Causes changes in attention, learning and memory, sleep and wakefulness, mood. Give also the mechanism of action.

Clozapine

Clients who are being treated with this drug must have a baseline WBC count and differential before initiation of treatment and a WBC count every week throughout treatment and for 4 weeks after discontinuation of the drug.

ziprasidone (Geodon)

Contraindicated in patients with a known history of QT prolongation, recent myocardial infarction, or uncompensated heart failure, it should not be used with other QT-prolonging drugs.

Histamine; Neuromodulator

Controls alertness, gastric secretions, cardiac stimulation, peripheral allergic responses. Give also the mechanism of action.

Dopamine; Excitatory

Controls complex movements, motivation, cognition; regulates emotional response. Give also the mechanism of action.

Epinephrine (adrenaline); Excitatory

Controls fight or flight response. Give also the mechanism of action.

Serotonin; Inhibitory

Controls food intake, sleep and wakefulness, temperature regulation, pain control, sexual behaviors, regulation of emotions. Give also the mechanism of action.

Acetylcholine; Excitatory or inhibitory

Controls sleep and wakefulness cycle; signals muscles to become alert. Give also the mechanism of action.

Introjection

EGO DEFENSE MECHANISM: Accepting another person's attitudes, beliefs, and values as one's own

Reaction formation

EGO DEFENSE MECHANISM: Acting the opposite of what one thinks or feels

Suppression

EGO DEFENSE MECHANISM: Conscious exclusion of unacceptable thoughts and feelings from conscious awareness

Dissociation

EGO DEFENSE MECHANISM: Dealing with emotional conflict by a temporary alteration in consciousness or identity

Repression

EGO DEFENSE MECHANISM: Excluding emotionally painful or anxiety-provoking thoughts and feelings from conscious awareness

Rationalization

EGO DEFENSE MECHANISM: Excusing own behavior to avoid guilt, responsibility, conflict, anxiety, or loss of self-respect

Undoing

EGO DEFENSE MECHANISM: Exhibiting acceptable behavior to make up for or negate unacceptable behavior

Conversion

EGO DEFENSE MECHANISM: Expression of an emotional conflict through the development of a physical symptom, usually sensorimotor in nature

Denial

EGO DEFENSE MECHANISM: Failure to acknowledge an unbearable condition; failure to admit the reality of a situation or how one enables the problem to continue

Fixation

EGO DEFENSE MECHANISM: Immobilization of a portion of the personality resulting from unsuccessful completion of tasks in a developmental stage

Identification

EGO DEFENSE MECHANISM: Modeling actions and opinions of influential others while searching for identity, or aspiring to reach a personal, social, or occupational goal

Regression

EGO DEFENSE MECHANISM: Moving back to a previous developmental stage to feel safe or have needs met

Compensation

EGO DEFENSE MECHANISM: Overachievement in one area to offset real or perceived deficiencies in another area

Resistance

EGO DEFENSE MECHANISM: Overt or covert antagonism toward remembering or processing anxiety-producing information

Substitution

EGO DEFENSE MECHANISM: Replacing the desired gratification with one that is more readily available

Intellectualization

EGO DEFENSE MECHANISM: Separation of the emotions of a painful event or situation from the facts involved; acknowledging the facts but not the emotions

Sublimation

EGO DEFENSE MECHANISM: Substituting a socially acceptable activity for an impulse that is unacceptable

Projection

EGO DEFENSE MECHANISM: Unconscious blaming of unacceptable inclinations or thoughts on an external object

Displacement

EGO DEFENSE MECHANISM: Ventilation of intense feelings toward persons less threatening than the one who aroused those feelings

DAYS TO WEEKS: A- ACUTE DYSTONIA D- WEEKS TO MONTHS: A- AKATHISIA P-PARKINSONISM/PSUEDOPARKINSONISM MONTHS TO YEARS: T- TARDIVE DYSKENSIA

EXTRAPYRAMIDAL SYMPTOMS ASSOCIATED W/ TYPICAL ANTIPSYCHOTICS:

Neuropeptides; Neuromodulators

Enhance, prolong, inhibit, or limit the effects of principal neurotransmitters. Give also the mechanism of action.

Ego integrity vs. despair (maturity); Wisdom

Erikson's Stages of Psychosocial Development: (STAGE AND VIRTUE) Accepting responsibility for oneself and life

Autonomy vs. shame and doubt (toddler); Will

Erikson's Stages of Psychosocial Development: (STAGE AND VIRTUE) Achieving a sense of control and free will

Initiative vs. guilt (preschool); Purpose

Erikson's Stages of Psychosocial Development: (STAGE AND VIRTUE) Beginning development of a conscience; learning to manage conflict and anxiety

Generativity vs. stagnation (middle adult); Care

Erikson's Stages of Psychosocial Development: (STAGE AND VIRTUE) Being creative and productive; establishing the next generation

Industry vs. inferiority (school age); Competence

Erikson's Stages of Psychosocial Development: (STAGE AND VIRTUE) Emerging confidence in own abilities; taking pleasure in accomplishments

Intimacy vs. isolation (young adult); Love

Erikson's Stages of Psychosocial Development: (STAGE AND VIRTUE) Forming adult, loving relationships, and meaningful attachments to others

Identity vs. role confusion (adolescence); Fidelity

Erikson's Stages of Psychosocial Development: (STAGE AND VIRTUE) Formulating a sense of self and belonging

Trust vs. mistrust (infant); Hope

Erikson's Stages of Psychosocial Development: (STAGE AND VIRTUE) Viewing the world as safe and reliable; relationships as nurturing, stable, and dependable

individual, interpersonal, and social/cultural

Factors influencing a person's mental health can be categorized as: _____, _______, and _________

Mature or aged cheeses or dishes made with cheese, such as lasagna or pizza. All cheese is considered aged except cottage cheese, cream cheese, ricotta cheese, and processed cheese slices. • Aged meats such as pepperoni, salami, mortadella, summer sausage, beef logs, meat extracts, and similar products. Make sure meat and chicken are fresh and have been properly refrigerated. • Italian broad beans (fava), bean curd (tofu), banana peel, overripe fruit, and avocado. • All tap beers and microbrewery beer. Drink no more than two cans or bottles of beer (including nonalcoholic beer) or 4 oz of wine per day. • Sauerkraut, soy sauce or soybean condiments, or marmite (concentrated yeast). • Yogurt, sour cream, peanuts, brewer's yeast, and monosodium glutamate (MSG).

Foods (Containing Tyramine) to Avoid When Taking Monoamine Oxidase Inhibitors

Five Stages of Psychosexual Development

Freud based his theory of childhood development on the belief that sexual energy, termed libido, was the driving force of human behavior.

subconscious

Freud believed that a person's dreams reflect his or her _________ and have significant meaning, though sometimes the meaning is hidden or symbolic.

conscious, preconscious, and unconscious

Freud believed that the human personality functions at three levels of awareness:

Id, Ego, and Superego

Freud conceptualized personality structure as having three components: ______, ________, & _________.

Anal; 18-36 months

Freud's Developmental Stages: (Phase and Age) Anus and surrounding area are major source of interest. Voluntary sphincter control (toilet training) is acquired.

Phallic/oedipal; 3-5 years

Freud's Developmental Stages: (Phase and Age) Genital is the focus of interest, stimulation, and excitement. Penis is organ of interest for both sexes. Masturbation is common. Penis envy (wish to possess penis) is seen in girls; oedipal complex (wish to marry opposite-sex parent and be rid of same-sex parent) is seen in boys and girls.

Latency; 5-11 or 13 years

Freud's Developmental Stages: (Phase and Age) Resolution of oedipal complex. Sexual drive channeled into socially appropriate activities such as school work and sports. Formation of the superego. Final stage of psychosexual development.

Oral; Birth to 18 months

Freud's Developmental Stages: Phase and Age: Major site of tension and gratification is the mouth, lips, and tongue; includes biting and sucking activities. Id is present at birth. Ego develops gradually from rudimentary structure present at birth.

Genital; 11-13 years

Freud's Developmental Stages: (Phase and Age) Begins with puberty and the biologic capacity for orgasm; involves the capacity for true intimacy.

Aristotle (382-322 BC)

He attempted to relate mental disorders to physical disorders and developed his theory that the amounts of blood, water, and yellow and black bile in the body controlled the emotions.

Humanistic Theories

Humanism represents a significant shift away from the psychoanalytic view of the individual as a neurotic, impulse-driven person with repressed psychic problems and away from the focus on and examination of the client's past experiences.

Childhood and Society

In 1950, Erikson published _____________, in which he described eight psychosocial stages of development. In each stage, the person must complete a life task that is essential to his or her well-being and mental health.

bloodletting, starving, and purging

In ancient times, Imbalances of the four humors (happiness, calmness, anger, and sadness) were believed to cause mental disorders; therefore, treatment was aimed at restoring balance through? Such "treatments" persisted well into the 19th century.

possessed

In early Christian times (1-1000 AD), primitive beliefs and superstitions were strong. All diseases were again blamed on demons, and the mentally ill were viewed as?

England during the Renaissance (1300-1600)

In this time, people with mental illness were distinguished from criminals. Those considered harmless were allowed to wander the countryside or live in rural communities, but the more "dangerous lunatics" were thrown in prison, chained, and starved

Cerebrum

Is divided into two hemispheres; all lobes and structures are found in both halves except for the pineal body, or gland, which is located between the hemispheres.

hierarchy of needs

Maslow (1954) formulated the ____________, in which he used a pyramid to arrange and illustrate the basic drives or needs that motivate people.

Gamma-aminobutyric acid (γ-aminobutyric acid, or GABA); Inhibitory

Modulates other neurotransmitters. Give also the mechanism of action

Genetics and Heredity Stress and the Immune System (Psychoimmunology) Infection as a Possible Cause

NEUROBIOLOGIC CAUSES OF MENTAL ILLNESS

two; single

PET uses _____ photons simultaneously; SPECT uses a ______ photon.

healthy

People who can carry out their roles in society and whose behavior is appropriate and adaptive are viewed as?

therapeutic nurse-patient relationship

Peplau developed the concept of the _____________, which includes four phases: orientation, identification, exploitation, and resolution

Client Teaching • Inform clients about the types of side effects that may occur. • Encourage client to report such problems to the physician instead of discontinuing the medication. • Teach the client methods of managing or avoiding side effects and maintaining the medication regimen. • Drinking sugar free fluids and eating sugar free hard candy ease the dry mouth. • To prevent constipation, include exercise and increase water and bulk forming foods in the diet. • avoid driving and performing other potentially dangerous activities until their response times and reflexes seem normal. • Use of sunscreen due to photosensitivity. • Monitor the amount of sleepiness or drowsiness. • If client forgets the medication, he can take the missed dose if its 3 or 4 hours late. More than 4 hours, omit the forgotten dose. • Clients who have difficulty remembering should use chart and record doses or use pillbox.

READ CLIENT TEACHING

• The use of radioactive substances in PET and SPECT limits the number of times a person can undergo these tests. There is the risk that the client will have an allergic reaction to the substances. Some clients may find receiving intravenous doses of radioactive material frightening or unacceptable. • Imaging equipment is expensive to purchase and maintain, so availability can be limited. A PET camera costs about $2.5 million; a PET scanning facility may take up to $6 million to establish. • Some persons cannot tolerate these procedures because of fear or claustrophobia. • Researchers are finding that many of the changes in disorders such as schizophrenia are at the molecular and chemical levels and cannot be detected with current imaging techniques (Gur & Gur, 2017).

READ LIMITATIONS OF BRAIN IMAGING TECHNIQUES

• A medication is selected based on its effect on the client's target symptoms such as delusional thinking, panic attacks, or hallucinations. The medication's effectiveness is evaluated largely by its ability to diminish or eliminate the target symptoms. • Many psychotropic drugs must be given in adequate dosages for some time before their full effects are realized. For example, tricyclic antidepressants can require 4 to 6 weeks before the client experiences optimal therapeutic benefit. • The dosage of medication is often adjusted to the lowest effective dosage for the client. Sometimes a client may need higher dosages to stabilize his or her target symptoms, while lower dosages can be used to sustain those effects over time. • As a rule, older adults require lower dosages of medications than do younger clients to experience therapeutic effects. It may also take longer for a drug to achieve its full therapeutic effect in older adults. • Psychotropic medications are often decreased gradually (tapering) rather than abruptly. This is because of potential problems with rebound (temporary return of symptoms), recurrence (of the original symptoms), or withdrawal (new symptoms resulting from discontinuation of the drug). • Follow-up care is essential to ensure compliance with the medication regimen, to make needed adjustments in dosage, and to manage side effects. • Compliance with the medication regimen is often enhanced when the regimen is as simple as possible in terms of both the number of medications prescribed and the number of daily doses.

READ Principles that Guide Pharmacologic Treatment

Glutamate; Excitatory

Results in neurotoxicity if levels are too high. Give also the mechanism of action.

Revolving door

Shorter unplanned hospital stays further complicate frequent repeated hospital admissions. People with severe and persistent mental illness may show signs of improvement in a few days but are not stabilized. Thus, they are discharged into the community without being able to cope with community living.

Infection as a Possible Cause

Some researchers are focusing on infection as a cause of mental illness. Most studies involving viral theories have focused on schizophrenia, but so far, none has provided specific or conclusive evidence.

Therapeutic Community or Milieu

Sullivan envisioned the goal of treatment as the establishment of satisfying interpersonal relationships. The therapist provides a corrective interpersonal relationship for the client.

infancy, childhood, juvenile, preadolescence, and adolescence,

Sullivan established five life stages of development—

Adolescence; Puberty to adulthood

Sullivan's Life Stages (STAGE AND AGE) Lust is added to interpersonal equation. Need for special sharing relationship shifts to the opposite sex. New opportunities for social experimentation lead to the consolidation of self-esteem or self-ridicule. If the self-system is intact, areas of concern expand to include values, ideals, career decisions, and social concerns.

Preadolescence; 8-12 years

Sullivan's Life Stages (STAGE AND AGE) Move to genuine intimacy with friend of the same sex. Move away from family as source of satisfaction in relationships. Major shift to syntaxic mode occurs. Capacity for attachment, love, and collaboration emerges or fails to develop. Lust is added to interpersonal equation.

Childhood; Language to 5 years

Sullivan's Life Stages (STAGE AND AGE) Parents are viewed as source of praise and acceptance. Shift to parataxic mode; experiences are connected in sequence to each other. Primary zone is anal. Gratification leads to positive self-esteem. Moderate anxiety leads to uncertainty and insecurity; severe anxiety results in self-defeating patterns of behavior.

Infancy (birth to onset of language)

Sullivan's Life Stages (STAGE AND AGE) Primary need exists for bodily contact and tenderness. Prototaxic mode dominates (no relation between experiences). Primary zones are oral and anal. If needs are met, infant has sense of well-being; unmet needs lead to dread and anxiety.

Juvenile; 5-8 years

Sullivan's Life Stages (STAGE AND AGE) Shift to the syntaxic mode begins (thinking about self and others based on analysis of experiences in a variety of situations). Opportunities for approval and acceptance of others. Learn to negotiate own needs. Severe anxiety may result in a need to control or in restrictive, prejudicial attitudes.

• To understand the progression of disease in order to identify the disease and implement (this is a purpose of pathophysiology)

The DSM-5 has three purposes, except: • To provide a standardized nomenclature and language for all mental health professionals • To present defining characteristics or symptoms that differentiate specific diagnoses • To understand the progression of disease in order to identify the disease and implement treatment options for their patients • To assist in identifying the underlying causes of disorders

Family Education.

The National Alliance for the Mentally Ill (NAMI) developed a unique 12-week Family-to-Family Education Course taught by trained family members. The curriculum focuses on schizophrenia, bipolar disorder, clinical depression, panic disorder, and obsessive-compulsive disorder.

frontal, parietal, temporal, and occipital

The cerebral hemispheres are divided into four lobes:

psychotherapy group

The goal of a ______________ is for members to learn about their behavior and to make positive changes in their behavior by interacting and communicating with others as a member of a group.

1963; Community Mental Health Centers Construction Act.

The movement toward treating those with mental illness in less restrictive environments gained momentum in _____ with the enactment of the _______

Drugs Used to Treat Extrapyramidal Side Effects

These drugs are for what? -Amantadine (Symmetrel) -Benztropine (Cogentin) -Biperiden (Akineton) -Diazepam (Valium) -Diphenhydramine (Benadryl) -Lorazepam (Ativan -Procyclidine (Kemadrin) -Propranolol (Inderal) 1 -Trihexyphenidyl (Artane)

Mental illness

This includes disorders that affect mood, behavior, and thinking, such as depression, schizophrenia, anxiety disorders, and addictive disorders.

occipital lobes

This lobe assists in coordinating language generation and visual interpretation, such a depth perception.

frontal lobes

This lobe control the organization of thought, body movement, memories, emotions, and moral behavior.

parietal lobes

This lobe interpret sensations of taste and touch and assist in spatial orientation.

temporal lobes

This lobe is centers for the senses of smell and hearing and for memory and emotional expression.

twin studies- used to compare the rates of certain mental illnesses or traits in monozygotic (identical) twins, who have an identical genetic makeup, and dizygotic (fraternal) twins, who have a different genetic makeup. adoption studies- used to determine a trait among biologic versus adoptive family members. Family studies- used to compare whether a trait is more common among first-degree relatives (parents, siblings, and children) than among more distant relatives or the general population.

Three types of studies are commonly conducted to investigate the genetic basis of mental illness:

Third-generation antipsychotics

What antipsychotic drugs are these: -Aripiprazole (Abilify) -Cariprazine (Vraylar) -Brexpiprazole (Rexulti)

Atypical or second-generation antipsychotics

What antipsychotic drugs are these: -Clozapine (Clozaril) -Fazaclo (clozapine) -Risperidone (Risperdal) -Olanzapine (Zyprexa) -Quetiapine (Seroquel) -Ziprasidone (Geodon) -Paliperidone (Invega) -Iloperidone (Fanapt) -Asenapine (Saphris) -Lurasidone (Latuda)

Conventional or first-generation antipsychotics

What antipsychotic drugs are these: -Phenothiazines -Chlorpromazine -Perphenazine (Trilafon) -Fluphenazine (Prolixin) -Thioridazine (Mellaril) -Mesoridazine (Serentil) -Trifluoperazine (Stelazine) -Thioxanthene -Thiothixene (Navane) -Butyrophenones -Haloperidol (Haldol) -Droperidol (Inapsine) -Dibenzazepine -Loxapine (Loxitane)

Sensorimotor (birth-2 years) Preoperational (2 to 6 years) Concrete operations (6 to 12 years) Formal operations (12 to 15 years and beyond)

What are Piaget's four stages of cognitive development

• Alternative medical systems • Mind-Body Interventions • Biologically based therapies • Manipulative and body based therapies • Energy therapies

What are the Complementary and Alternative Therapies

hope, purpose, fidelity, love, caring, and wisdom

What are the life's virtues acc. to erik erikson?

1547; the Hospital of St. Mary of Bethlehem

When and what hospital was officially declared for the insane?

Sigmund Freud

Who is The Father of Psychoanalysis

Managed care

a concept designed to purposely control the balance between the quality of care provided and the cost of that care.

Medication management

a crucial issue that greatly influences the outcomes of treatment for many clients with mental disorders. The following sections discuss several categories of drugs used to treat mental disorders

Deinstitutionalization

a deliberate shift from institutional care in state hospitals to community facilities.

Family therapy

a form of group therapy in which the client and his or her family members participate. The goals include understanding how family dynamics contribute to the client's psychopathology, mobilizing the family's inherent strengths and functional resources, restructuring maladaptive family behavioral styles, and strengthening family problem-solving behaviors

Individual psychotherapy

a method of bringing about change in a person by exploring his or her feelings, attitudes, thinking, and behavior. It involves a one-to-one relationship between the therapist and the client.

Unconditional positive

a nonjudgmental caring for the client that is not dependent on the client's behavior

group

a number of persons who gather in a face-to-face setting to accomplish tasks that require cooperation, collaboration, or working together.

Hildegard Peplau

a nursing theorist and clinician who built on Sullivan's interpersonal theories and also saw the role of the nurse as a participant observer.

corpus callosum

a pathway connecting the two hemispheres and coordinating their functions.

Dream analysis

a primary technique used in psychoanalysis, involves discussing a client's dreams to discover their true meaning and significance.

Behaviorism

a school of psychology that focuses on observable behaviors and what one can do externally to bring about behavior changes. It does not attempt to explain how the mind works.

Tardive Dyskinesia. Tardive dyskinesia (TD),

a syndrome of permanent involuntary movements, is most commonly caused by the long-term use of conventional antipsychotic drugs. About 20% to 30% of patients on long term treatment develop symptoms of TD, and the pathophysiology is still unclear. The symptoms of this include involuntary movements of the tongue, facial and neck muscles, upper and lower extremities, and truncal musculature.

Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5)

a taxonomy published by the American Psychiatric Association and revised as needed. It describes all mental disorders, outlining specific diagnostic criteria for each based on clinical experience and research.

Freudian slip

a term we commonly use to describe slips of the tongue—for example, saying "You look portly today" to an overweight friend instead of "You look pretty today."

magnetic resonance imaging (MRI)

a type of body scan, an energy field is created with a huge magnet and radio waves. The energy field is converted to a visual image or scan.

Harry Stack Sullivan (1892-1949)

an American psychiatrist who extended the theory of personality development to include the significance of interpersonal relationships. He believed that one's personality involves more than individual characteristics, particularly how one interacts with others.

Abraham Maslow

an American psychologist who studied the needs or motivations of the individual. He differed from previous theorists in that he focused on the total person, not just on one facet of the person, and emphasized health instead of simply illness and problems.

B.F. Skinner

an American psychologist. He developed the theory of operant conditioning, which says people learn their behaviors from their history or past experiences, particularly those experiences that were repeatedly reinforced.

limbic system

an area of the brain located above the brain stem that includes the thalamus, hypothalamus, hippocampus, and amygdala

pineal body

an endocrine gland that influences the activities of the pituitary gland, islets of Langerhans, parathyroids, adrenals, and gonads.

Standards of care

are authoritative statements by professional organizations that describe the responsibilities for which nurses are accountable.

Manipulative and body-based therapies

are based on manipulation or movement of one or more parts of the body, such as therapeutic massage and chiropractic or osteopathic manipulation.

Psychosocial interventions

are nursing activities that enhance the client's social and psychological functioning and improve social skills, interpersonal relationships, and communication.

Open groups

are ongoing and run indefinitely, allowing members to join or leave the group as they need to.

Support Groups

are organized to help members who share a common problem cope with it. The group leader explores members' thoughts and feelings and creates an atmosphere of acceptance so that members feel comfortable expressing themselves. They often provide a safe place for group members to express their feelings of frustration, boredom, or unhappiness and also to discuss common problems and potential solutions.

Antidepressant drugs

are primarily used in the treatment of major depressive illness, anxiety disorders, the depressed phase of bipolar disorder, and psychotic depression.

Closed groups

are structured to keep the same members in the group for a specified number of sessions.

Neurotransmitters

are the chemical substances manufactured in the neuron that aid in the transmission of information throughout the body.

positron emission tomography (PET) and single-photon emission computed tomography (SPECT),

are used to examine the function of the brain. Radioactive substances are injected into the blood; the flow of those substances in the brain is monitored as the client performs cognitive activities as instructed by the operator.

anxiolytic drugs,

are used to treat anxiety and anxiety disorders, insomnia, obsessive-compulsive disorder (OCD), depression, posttraumatic stress disorder, and alcohol withdrawal.

Mood-stabilizing drugs

are used to treat bipolar disorder by stabilizing the client's mood, preventing or minimizing the highs and lows that characterize bipolar illness, and treating acute episodes of mania.

parataxic mode

begins in early childhood as the child begins to connect experiences in sequence. The child may not make logical sense of the experiences and may see them as coincidence or chance events.

syntaxic mode

begins to appear in school-aged children and becomes more predominant in preadolescence, the person begins to perceive him or herself and the world within the context of the environment and can analyze experiences in a variety of settings. Maturity may be defined as predominance of this mode.

Ancient Times

believed that any sickness indicated displeasure of the gods and, in fact, was a punishment for sins and wrongdoing.

prototaxic mode

characteristic of infancy and childhood, involves brief, unconnected experiences that have no relationship to one another. Adults with schizophrenia exhibit persistent prototaxic experiences.

group therapy

clients participate in sessions with a group of people. The members share a common purpose and are expected to contribute to the group to benefit others and receive benefit from others in return. family therapy, education groups, support groups, Self help groups

Integrative medicine

combines conventional medical therapy and CAM therapies that have scientific evidence supporting their safety and effectiveness.

Central Nervous System

comprises the brain, the spinal cord, and associated nerves that control voluntary acts. Structurally, the brain consists of the cerebrum, cerebellum, brain stem, and limbic system.

midbrain

connects the pons and cerebellum with the cerebrum.

right hemisphere

controls the left side of the body and is the center for creative thinking, intuition, and artistic abilities.

left hemisphere

controls the right side of the body and is the center for logical reasoning and analytic functions such as reading, writing, and mathematical tasks.

Potency

describes the amount of the drug needed to achieve that maximum effect;

Individual, or personal

factors include a person's biologic makeup, autonomy and independence, self-esteem, capacity for growth, vitality, ability to find meaning in life, emotional resilience or hardiness, sense of belonging, reality orientation, and coping or stress management abilities.

Social/cultural, or environmental

factors include a sense of community, access to adequate resources, intolerance of violence, support of diversity among people, mastery of the environment, and a positive, yet realistic, view of one's world

Interpersonal, or relationship

factors include effective communication, ability to help others, intimacy, and a balance of separateness and connectedness

Client-centered therapy

focuses on the role of the client, rather than the therapist, as the key to the healing process. Rogers believed that each person experiences the world differently and knows his or her own experience best

Antipsychotic drugS

formerly known as neuroleptics, are used to treat the symptoms of psychosis, such as the delusions and hallucinations seen in schizophrenia, schizoaffective disorder, and the manic phase of bipolar disorder.

Benzodiazepines

have proved to be the most effective in relieving anxiety and are the drugs most frequently prescribed.

Sigmund Freud (1856-1939)

he developed psychoanalytic theory in the late 19th and early 20th centuries in Vienna, where he spent most of his life.

Jean Piaget (1896-1980)

he explored how intelligence and cognitive functioning develop in children. He believed that human intelligence progresses through a series of stages based on age, with the child at each successive stage demonstrating a higher level of functioning than at previous stages.

Empathetic understanding

in which the therapist senses the feelings and personal meaning from the client and communicates this understanding to the client

Alternative medical systems

include homeopathic medicine and naturopathic medicine in Western cultures, and traditional Chinese medicine, which includes herbal and nutritional therapy, restorative physical exercises (yoga and tai chi), meditation, acupuncture, and remedial massage.

Mind-body interventions

include meditation, prayer, mental healing, and creative therapies that use art, music, or dance.

Energy therapies

include two types of therapy: biofield therapies, intended to affect energy fields that are believed to surround and penetrate the body, such as therapeutic touch, qi gong, and Reiki, and bioelectric-based therapies involving the unconventional use of electromagnetic fields, such as pulsed fields, magnetic fields, and alternating current or direct current fields. Qi gong is part of Chinese medicine that combines movement, meditation, and regulated breathing to enhance the flow of vital energy and promote healing. Reiki (which in Japanese means "universal life energy") is based on the belief that when spiritual energy is channeled through a Reiki practitioner, the patient's spirit and body are healed.

dystonia

includes acute muscular rigidity and cramping, a stiff or thick tongue with difficulty swallowing, and, in severe cases, laryngospasm and respiratory difficulties.

brain stem

includes the midbrain, pons, and medulla oblongata and the nuclei for cranial nerves III through XII.

Alternative medicine

includes therapies used in place of conventional treatment.

Complementary medicine

includes therapies used with conventional medicine practices (the medical model).

hippocampus and amygdala

involved in emotional arousal and memory.

hypothalamus

involved in temperature regulation, appetite control, endocrine function, sexual drive, and impulsive behavior associated with feelings of anger, rage, or excitement.

Psychiatric rehabilitation

involves providing services to people with severe and persistent mental illness to help them to live in the community. These programs are often called community support services or community support programs. It focuses on the client's strengths, not just on his or her illness.

Neuroleptic Malignant Syndrome. Neuroleptic malignant syndrome (NMS)

is a potentially fatal idiosyncratic reaction to an antipsychotic (or neuroleptic) drug. The major symptoms of this are rigidity; high fever; autonomic instability such as unstable blood pressure, diaphoresis, and pallor; delirium; and elevated levels of enzymes, particularly creatine phosphokinase.

Computed tomography (CT)

is a procedure in which a precise x-ray beam takes cross-sectional images (slices) layer by layer.

Disulfiram (Antabuse)

is a sensitizing agent that causes an adverse reaction when mixed with alcohol in the body. This agent's only use is as a deterrent to drinking alcohol in persons receiving treatment for alcoholism. It is useful for persons who are motivated to abstain from drinking and who are not impulsive.

Suicide

is always a primary consideration when treating clients with depression.

Toxicity

is closely related to serum lithium levels and can occur at therapeutic doses. Facilities for serum lithium determinations are required to monitor therapy.

Drug-induced parkinsonism, or pseudoparkinsonism,

is often referred to by the generic label of EPS. Symptoms resemble those of Parkinson disease and include a stiff, stooped posture; masklike facies; decreased arm swing; a shuffling, festinating gait (with small steps); cogwheel rigidity (ratchet-like movements of joints); drooling; tremor; bradycardia; and coarse pill-rolling movements of the thumb and fingers while at rest.

Akathisia

is reported by the client as an intense need to move about. The client appears restless or anxious and agitated, often with a rigid posture or gait and a lack of spontaneous gestures.

U.S. Food and Drug Administration (FDA)

is responsible for supervising the testing and marketing of medications for public safety. These activities include clinical drug trials for new drugs and monitoring the effectiveness and side effects of medications.

Lithium

is the most established mood stabilizer;

medulla

located at the top of the spinal cord, contains vital centers for respiration and cardiovascular functions.

cerebellum

located below the cerebrum and is the center for coordination of movements and postural adjustments. It receives and integrates information from all areas of the body, such as the muscles, joints, organs, and other components of the CNS.

Self-Help Groups

members share a common experience, but the group is not a formal or structured therapy group. Although professionals organize some self-help groups, many are run by members and do not have a formally identified leader.

ego defense mechanisms

methods of attempting to protect the self and cope with basic drives or emotionally painful thoughts, feelings, or events.

Transference

occurs when the client displaces onto the therapist attitudes and feelings that the client originally experienced in other relationships

Countertransference

occurs when the therapist displaces onto the client attitudes or feelings from his or her past.

Anticholinergic Side Effects

often occur with the use of antipsychotics and include orthostatic hypotension, dry mouth, constipation, urinary hesitance or retention, blurred near vision, dry eyes, photophobia, nasal congestion, and decreased memory.

Genuineness

realness or congruence between what the therapist feels and what he or she says to the client

Group process

refers to the behavior of the group and its individual members, including seating arrangements, tone of voice, who speaks to whom, who is quiet, and so forth.

Efficacy

refers to the maximal therapeutic effect that a drug can achieve.

Conscious

refers to the perceptions, thoughts, and emotions that exist in the person's awareness, such as being aware of happy feelings or thinking about a loved one.

Group content

refers to what is said in the context of the group, including educational material, feelings and emotions, or discussions of the project to be completed.

Psychoimmunology,

relatively new field of study, examines the effect of psychosocial stressors on the body's immune system. A compromised immune system could contribute to the development of a variety of illnesses, particularly in populations already genetically at risk.

Case management

represented an effort to provide necessary services while containing cost.

asylum

safe refuge or haven offering protections at institutions where people had been whipped, beaten, and starved because they were mentally ill.

operant conditioning

says people learn their behaviors from their history or past experiences, particularly those experiences that were repeatedly reinforced.

Extrapyramidal Side Effects. Extrapyramidal symptoms (EPSs),

serious neurologic symptoms, are the major side effects of antipsychotic drugs. They include acute dystonia, pseudoparkinsonism, and akathisia.

Stimulant drugs

specifically amphetamines, were first used to treat psychiatric disorders in the 1930s for their pronounced effects on CNS stimulation.

Psychoanalytic theory

supports the notion that all human behavior is caused and can be explained (deterministic theory).

self-actualization

term used to describe a person who has achieved all the needs of the hierarchy and has developed his or her fullest potential in life.

ego

the balancing or mediating force between the id and the superego.

superego

the part of a person's nature that reflects moral and ethical concepts, values, and parental and social expectations; therefore, it is in direct opposition to the id.

id

the part of one's nature that reflects basic or innate desires such as pleasure seeking behavior, aggression, and sexual impulses. It seeks instant gratification, causes impulsive unthinking behavior, and has no regard for rules or social convention.

unconscious

the realm of thoughts and feelings that motivates a person even though he or she is totally unaware of them.

Sigmund Freud and Treatment of Mental Disorders

the study of psychiatry and the diagnosis and treatment of mental illness started in earnest.

Half life

the time it takes for half of the drug to be removed from the bloodstream.

high-potency drugs

these drugs achieve efficacy at lower dosages.

low-potency drugs

these drugs require higher dosages to achieve efficacy,

Chlorpromazine (Thorazine), an antipsychotic drug, and lithium, an antimanic agent

these were the first drugs to be developed.

First-generation antipsychotic drugs

this generation of antipsychotic drugs cause a greater incidence of EPSs

black box warning.

this means that package inserts must have a highlighted box, separate from the text which contains the serious life- threatening side-effects.

ill

those who fail to fulfill roles and carry out responsibilities or whose behavior is inappropriate are viewed as?

Preconscious

thoughts and emotions are not currently in the person's awareness, but he or she can recall them with some effort—for example, an adult remembering what he or she did, thought, or felt as a child.

education group

to provide information to members on a specific issue—for instance, stress management, medication management, or assertiveness training.

Biologically based therapies

use substances found in nature, such as herbs, food, and vitamins. Dietary supplements, herbal products, medicinal teas, aromatherapy, and a variety of diets are included.

Erik Erikson (1902-1994)

was a German-born psychoanalyst, who extended Freud's work on personality development across the life span while focusing on social and psychological development in the life stages.

Carl Rogers

was a humanistic American psychologist who focused on the therapeutic relationship and developed a new method of client centered therapy.

Schizoprenia

↑Dopamine is related to what mental disorder

Alzeheimer's Disease (AD)

↓Acetylcholine is related to what mental disorder

Anxiety

↓GABA is related to what mental disorder

Depression

↓norepinephrine is related to what mental disorder

Depression

↓serotonin is related to what mental disorder