You are on page 1of 42

Psychiatric Nursing Exam #1 Study Guide

Chapter 1
1. Define deviance.
Behavior outside the social norm of a specific group
2. Define crazy.
An informal, denigrating, and stigmatizing term for "mentally
ill" that carries with it unfounded and negative implications
3. What is a nervous breakdown?
A general, nonspecific term for an incapacitating but
otherwise unspecified type of mental disorder
4. What is a mental disorder?
A psychological group of symptoms, such as a pattern or a
syndrome, in which the individual experiences distress (a
painful symptom), disability (impairment in one or more
important areas of functioning), or a significantly increased
risk of suffering, pain, loss of freedom, or death
5. What is psychopathology?
The above signs and symptoms of mental disorder
6. What is the #1 psychiatric disorder?
7. What is a "broken brain" vs. a "flabby mental health"?
Neurological problems (dysfunctions) vs. Acts inappropriate
on purpose
8. Describe the Era of Magico—Religious Explanations.
(Time frame and focus.)
From preliterature cultures. Mental and physical suffering
attributed to forces outside the body. No distinctions made
between medicine, magic, and religion. They believe in
taboos, neglect of rites, loss of soul from body, foreign or
harmful substance in body, and witchcraft.
9. Describe the Era of Organic Explanations. (Time frame
and focus.)
In the 4th Century BCE, Hippocrates proposed a medical
concept to explain mental suffering. Proposed that
psychiatric illnesses were caused mainly by imbalances in
body humors, NOT demonology: blood (manic), black bile
(melancholy/depressed), yellow bile, and phlegm (ineffective
decision maker).
10. Describe the Era of Alienation.

Middle Ages (400 CE - Renaissance). Madness seen as a
dramatic encounter with secret powers. Minds were thought
to be influenced by the moon (lunacy). Witch hunts. "Ships
of fools." Social abandonment.
11. Describe the Era of Confinement. (Time frame and
Renaissance (1300-1600 CE). Seventeenth-century. Mad
persons = right to be fed but were morally constrained and
physically confined. Threatening institution complete with
stakes, irons and dungeons. No right to appeal. Mad persons
were publicly tortured.
12. Describe the Era of Moral Treatment. (Time frame and
The 18th and early 19th centuries. Characterized by internal
contradictions. Unchained but tortured. The medical
treatment they received consisted of torture with special
paraphernalia. Mental disorders were believed to be
incurable, and mad persons were thought to be dangerous.
Illness couldn't be seen or explained and very feared.
13. During the Era of Moral Treatment, who led the
first person who led the movement that began to
release inmates from their chains, abolish
systematized brutality with chains and whips, feed
them nourishing foods, and treat them with kindness?
Philippe Pinel (1745-1826) in France and the Quakers in
England under William Tuke (1732-1822).
14. Who led the Moral treatment in the United states?
Benjamin Franklin and Benjamin Rush ("the father of
American Psychiatry", 1745-1813, a major follower of William
Cullen). Rush advocated bloodletting, the restraining chair,
the gyrating chair, and other devices that we now consider
15. What did Scotland's William Cullen (1710-1790)
Mental disorder was due to decay, either of the intellect of
the involuntary nervous system, that is, a matter of
disordered physiology.
16. Describe the Era of Psychoanalysis. (Time frame and

Late 19th and early 20th century. Insanity linked to faulty life
habits; treated with new forms of physical or somatic
therapies. Gradual assimilation into medicine. Treatments
varied. 1990's - decade of the brain.
17. Who is Sigmund Freud and what era did he form
background for his work based off its developments?
Sigmund Freud (1856-1939) is one of the most influential
figures in the history of psychiatry, and succeeded in
explaining human behavior in psychologic terms. Era of
18. Explain Contemporary Developments.
By the mid-20th century, psychiatric thinking was expanding
and moving toward and emphasis on the importance of the
social dimension. Drug treatment for mental illness was
being developed.
19. What was the primary innovation of the 1990s
called and what was it?
Biologic revolution: the collaboration of science and
technology to expand concepts of mental disorder proposed
by psychologic and behavioral theories.

Chapter 2
1. What is psychiatric-mental health nursing committed
They are committed to promoting mental health through the
assessment, diagnosis, and treatment of human responses
to mental health problems and psychiatric disorders.
2. What are essential components of psychiatric-mental
health nursing?
Health and wellness promotion though identification of
mental health issues. Prevention of mental health problems.
Care of mental health problems. Treatment of persons with
psychiatric disorders.
3. Timeline of the history of psychiatric nursing: (SHE
years is not important, but I would read over some of
the facts what is left of the timeline I have below– I
deleted over 75% of the timeline I had before and

only kept the facts I thought were most important.
1836 – Theodore and Friedericke Fliedner founded the first
systematic school of nursing in Germany.
1860s – Emergence of the discipline of psychiatric nursing.
Florence Nightingale founds school at Saint Thomas
Hospital in London. Nightingale among the first to note that
the influence of nurses on their own clients transcends
physical care.
1870s – The first three American nursing schools, organized
in the pattern of Saint Thomas Hospital, were opened in New
York, Boston, and New Haven.
1880 – Linda Richards, "the first American psychiatric
nurse", opened/directed the first American school for
psychiatric nurses at the first Psychiatric Asylum (McLean
Psychiatric Asylum) in Waverly, Massachusetts.
1946 – Passage of National Mental Health Act (the
government's response to growing recognition of mental
illness as a national health problem) develops
psychotherapeutic roles for nurses. This established the
National Institute of Mental Health (NIMH).
1952 – Three important milestones in psychiatric nursing
occurred. First, Hildegard Peplau published Interpersonal
Relations in Nursing, the first systematic theoretic
framework in psychiatric nursing. Emphasized
psychodynamic concepts and counseling techniques.
Second, Gwen Tudor Will demonstrates nursing interventions
with sociopsychiatric base. Published in Psychiatry –
Research: study of intervention to disrupt pattern of
avoidance occurring among medical, nursing and patient.
Third, Frances Sleeper APA advocates psychiatric nurses as
1954 – Under Peplau's leadership, the first graduate
degree in psychiatric-mental health nursing was awarded by
Rutgers University. She has had greater impact on
psychiatric nursing than any other nursing theoretician to
1969 – A psychiatric nurse had moved into private practice.

1973 – Certification in psychiatric nursing becomes the responsibility of the ANA. 4. Exploitation (or working). Define advanced practice registered nurse in psychiatric-mental health: A licensed registered nurse who is educationally prepared as a clinical nurse specialist or a nurse practitioner at the master's or doctorate degree level in the specialty of psychiatric-mental health nursing. or baccalaureate program (RNs). Identification. 1980s – Period of Decline and Retrenchment. 1984 – ANA Council of Specialists in Psychiatric and Mental Health Nursing develops a classification system for Psychiatric Nursing Diagnosis (added to NANDA). 7. What is the most significant piece of legislation affecting the development of psychiatric-mental health nursing? The National Mental Health Act of 1946 6. What were the four phases of the nurse-client relationship according to Peplau? Orientation. When did psychiatric-mental health nursing first begin? The late 19h and 20th centuries. associate degree. CS = Certified Specialist. Standards of Child and Adolescents Psychiatric and Mental Health Nursing and Standards of Addictions Nursing Practice published by ANA. and Resolution 8. Who is considered the "mother of psychiatric nursing? Hildegard Peplau 9. Standards of Psychiatric-Mental Health Nursing published by ANA. What is the difference between Basic Level of Practice and Advanced Level of Practice? Basic level Psychiatric-Mental Health Nurse (PMH) may have received basic nursing preparation in a diploma. Advanced Practice Registered Nurse (APRN-PMH) is a licensed registered nurse who is educationally prepared as a clinical nurse specialist or a nurse practitioner at the . 5.

Milieu The Psychiatric-Mental Health Therapy Registered Nurse provides. Diagnosis The Psychiatric-Mental Health Registered Nurse analyzes the assessment data to determine diagnosis or problems. Planning The Psychiatric-Mental Health Registered Nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes. structures. The Psychiatric-Mental Health Coordination of Care Registered Nurse coordinates care of delivery Standard 5 B. Outcomes The Psychiatric-Mental Health Identification Registered Nurse identified expected outcomes for a plan individualized to the patient or to the situation. 10. and maintains a safe and therapeutic environment in . The Psychiatric-Mental Health Implementation Registered Nurse implements the identified plan Standard 5 A. Assessment The Psychiatric-Mental Health Registered Nurse collects comprehensive health data that is pertinent to the patient's health or situation. What are the 6 Psychiatric-Mental Health Nursing Standards of Practice in relation to Basic Level and Advanced Level of Practice? Standard 1. master's or doctorate degree level in the specialty of psychiatric-mental health nursing. Health The Psychiatric-Mental Health Teaching and Health Registered Nurse employs Promotion strategies to promote health and a safe environment Standard 5 C. Standard 3. Standard 4. Standard 2. including level of risk. Standard 5.

referrals. Evaluation The Psychiatric-Mental Health Registered Nurse evaluates progress toward attainment of . biological. Standard 6. The Psychiatric-Mental Health Pharmacological. Prescriptive The Psychiatric-Mental Health Authority and Treatment Advanced Practice (APRN only) Registered Nurse uses prescriptive authority. The Psychiatric-Mental Health Psychotherapy (APRN Advanced Practice only) Registered Nurse conducts individual. couples. Standard 5 D. Registered Nurse Biological. and effect change. families. procedures. Standard 5 E. and therapies in accordance with state and federal laws and regulations. and other health care clinicians. and family psychotherapy using evidence-based psychotherapeutic frameworks and nurse-patient therapeutic relationships. and complementary interventions with applied clinical skills to restore the patient's health and prevent further disability. treatments. Standard 5 F. enhance the abilities of other clinicians to provide services for patients. collaboration with patients. The Psychiatric-Mental Health Consultation (APRN only) Advanced Practice Registered Nurse provides consultation to influence the identified plan. and Integrative incorporates knowledge of Therapies pharmacological. Standard 5 G. group.

. may perform counseling and psychotherapy. level of clients. disorders Clinical A psychologist specially Performs Psychologist educated and trained in psychotherapy. 11. may have identifies a doctoral degree. has major expertise depends on responsibility for education. has treatment of completed an approved persons with mental psychiatric residency. include up to the doctoral level. mental health. A registered nurse with Responsible for the Mental specialized preparation nursing care of Health Nurse in psychiatric-mental mental health health nursing. administers. Psychiatrist A medical physician Responsible for whose specialty is diagnosis and mental disorders. Psychiatric A graduate of a master's Helps clients and Social program in social work their families cope Worker with an emphasis in more effectively. their education/preparation and roles for the mental health team? Team Education/Preparation Role Member Psychiatric. and interprets psychological tests. expected outcomes. which may the milieu. What are the team members. plans and certification requires implements completion of an programs of approved doctoral behavior program and a clinical modifications. selects. appropriate community resources. internship. mental health.

and in colleges and literature to universities facilitate interpersonal experiences and increase social responses and self- esteem. Psychosocial Most have either a high Teaches clients Rehabillitatio school education or a practical. music. helps clients prepare to seek employment. Therapist informal or formal levels dance. day-to- n Worker bachelor's degree day skills for living in the community and provides case management . education programs healthful recreation.Marriage and May be a member of any Provides Family mental health discipline. psychotherapy Therapist usually prepared at the usually focusing on master's or doctoral couples or families level Occupational Prepared in occupational Uses manual and Therapist therapy at the creative techniques baccalaureate or to elicit desired master's level with a interpersonal and specialty in mental intrapsychic health care responses. Recreational May be prepared at Plans and guides Therapist informal or formal levels recreational in university physical activities to provide education and health socialization. and desirable interpersonal and intrapsychic experiences. teaches self-help activities. Creative Arts May be prepared at Uses art.

What are the four models of helping based on the issues of blame and control? Medical model: Believe that people are not responsible for own problems nor responsible to solve them. includes both blind and irrational belief. 9. services. Believing that people are responsible for solutions to their own problems involves the issue of control. only the tips stick up into consciousness. What is detached concern? Ability to distance oneself in order to help others. and the deeper parts are submerged. Irrational beliefs – beliefs held despite available evidence to the contrary. 7. What is dogmatic belief? Opinions or beliefs held as if they were based on the highest authority. What is self-awareness? How well the people know themselves. They will not be effective. Enlightenment Model: Believe that people are responsible for creating problems and need to rely on others for solution. What are the issues of blame and control? Believing that people cause their own problems involves the issue of blame. 3. 4. Based on personal experience. 8. False. What are the three major forms of beliefs and values? Rational beliefs – beliefs that are supported by available evidence. Compensatory Model: Believe that people are not to blame for problems but should assist in solving them. 6. negotiated reality. Feelings are like… Icebergs. What does it mean to create a common ground with a client? Creating a mutually understood. 2. 5. Chapter 3 1. . True or False: Nurses who cannot cope with their own feelings of depression can still be effective with severely depressed clients. Blind belief – belief in the absence of evidence.

Advocacy (support of mentally ill and political awareness). and actions. What is aggressive behavior? Inconsiderate. Empathy. What is an attitude? What is an opinion? Attitude = a feeling over a period of time. What is passive behavior? Don't want to say "no" 19. What is cognitive value? What is active values? Cognitive = verbally subscribing to values but failing to act on them. be said. Spirituality. preferences. offensive aggression 18. Active = Acting on verbalized values. 20. 10. 12. 13. Moral Model: Believe that people cause their own problems and should be responsible for developing solutions to them. Critical thinking (transfer . What is therapeutic alliance? A conscious. Accountability (psychiatric clients are most defenseless – requires clinical supervision). An attitude linked to an idea or belief becomes an opinion. decisions. or should. The person says "no" even when "yes" could. What is burnout? A condition in which health care professionals lose their concern and feeling for their clients and come to treat them in detached or even dehumanized ways. growth-facilitating relationship between a helping person (the psychiatric-mental health nurse) and the client 15. 16. How are values demonstrated? Through interests. What is nonassertive behavior? Timid holding back 17. What are 7 interpersonal qualities psychiatric nurse should have? Vision (to enhance people's quality of life). What are the three hallmarks of aggressive behavior? The major feeling is anger. What is assertive behavior? Asking for what one wants or acting to get it in a way that respects other people. The aggressive person believes that his or her feelings are more important than the feelings of others. 14. 11.

Level II Grade B . practice was based on what? Traditions and customs. 23. evidence (type of study) gives it a certain value. What is evidence-based practice? The integration of individual clinical expertise with the best available external clinical evidence from systematic research. Level I Grade A Evidence obtained from a Effectiveness established to a systematic review of all degree that merits relevant randomized. What is critical thinking? Purposeful. Chapter 4 1. What are the Levels of Evidence and Grades of Recommendation? Levels of Evidence Grades of Studies are categorized Recommendation based on the strength of the These are based on the JBI evidence. Clinical judgment. 3. at the core of each person's existence 22. application controlled trials. reasonable. Trial and error. knowledge into clinical practice). 2. and/or a belief in a higher power. reflective thinking that drives problem solving and decision making and aims to make judgments based on evidence. Before evidence-based practice. nature. graduated from Level I down to Level IV. The source of the grades of effectiveness. What is spirituality? The search for meaning and purpose in life through connection with others. Regulations. What is empathy? The ability to feel what others feel and respond to and understand the experience of others on their terms. Self-disclosure (open to personal feelings and experiences). 21.

attitudes. What is Meta-analysis? Analyzing the analysis of studies 6. degree that warrants controlled trials (alternate consideration of applying the allocation or some other findings. skills. method of assignment) Level III b Grade D Evidence obtained from Effectiveness established to a comparative studies with limited degree. controlled trial application Level III a Grade C Evidence obtained from well. 7. What are critical pathways? . What are clinical algorithms? They show a logical progression of decisions and activities that are designed to standardize quality care for a particular clinical intervention. concurrent controls and allocation not randomized (cohort studies). What are Best Practices? Broad consensus statements about values. Level IV Evidence obtained from case series. Evidence obtained from at Effectiveness established to a least one properly designed degree that suggests randomized. either posttest or pretest and posttest 4. two or more simple arm studies. Effectiveness established to a designed pseudorandomized. or interrupted time series with a control group Level III c Grade E Evidence obtained from Effectiveness not established comparative studies with historical control. knowledge. and approaches 5. case control studies. or interrupted time series with a parallel control group.

What did the Health Insurance Portability and Accountability Act (HIPAA) of 1996 create? Uniform standards for electronic health care transactions (EDI) and provides for security protections for data that are electronically stored and transmitted. They provide a means of accurate documentation and shift the emphasis from depicting nursing as a series of tasks (e. generated by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research in 1979. culture. etc. qualitative research? Quantitative research = Statistical analyses done on numerical data such as test scores or ratings of improvement or worsening of symptoms. prevent or remove harm. monitoring medication side effects. What are the 5 stages in the Transtheoretical Model (TTM) of change formulated by Prochaska and . given what is due or what is owed. 8. 11. taking vital signs. Qualitative research = data is interpreted in a way that examines the qualities of the experience for the participants. making sure we have provisions for what is fair. and promote good for research subjects.g. and there is respect for the subject's body. 12. and community as well as freedom from coercion. short and easily readable. What is the Belmont Report? An excellent resource for research basics.) to interventions connected to a purpose or client outcome. family. Justice = Focuses on how a person should be treated during research. 10. Researchers must inflict no harm (nonmaleficence). 13. Beneficence = means doing good. What is quantitative research vs. What are Practice Guidelines? Professional mandates for clinical practice 9. What are the three main principles on which research is focused and what do they mean? Respect for persons = includes the ethical consideration of autonomy: the research subject is valued. the researcher acknowledges boundaries.

Linking the problem with interventions and outcomes. schizophrenic s have trouble with this 2. interpreting. The person is on the cusp of changed behavior. Implementing and evaluating the change in practice. 15. What are illusions? . Action = Behavior. What are the 6 steps for change in the Model for Evidence-Based Practice created by Rosswurm and Larrabee (1999)? Assessing the need for change. Some small change in the direction of the overall goal may be made. DiClemente (1986) through which people progress when behavior modifications are desired? Precontemplation = The person has no intention to change behavior in the foreseeable future. Designing the change in practice. Maintenance = This stage involves the work necessary to keep the desired change in place and stabilize the person in the person in this new mode of behaving. Preparation = This stage combines the commitment to change with the intention to initiate action. Chapter 10 1. What does perception mean? The experience of sensing. What are randomized client trials? Studies designed to test hypotheses using the traditional experimental approach of randomly assigning subjects to treatment and control groups and then comparing them on identified and measureable outcomes in quantifiable terms. and environment are all modified to support the change. experiences. Contemplation = The person is aware of the need for change and is thinking about it but has not yet made the commitment to take action. What is ethnography? The study of human beings and their culture 16. and comprehending the world in which one lives – it is a highly personal and internal act. 14. Synthesizing the best evidence. Integrating and maintaining the change in practice.

What is a denotative meaning? What is a connotative meaning? Denotative = One that is in general use by most people who share a common language Connotative = Usually arises from a person's personal experience 5. If the other person returns the gaze. Does verbal or nonverbal communication carry more social meaning? Nonverbal communication 7. Foot shuffling/fidgeting = may express the desire to escape. 11. the invitation to interact has been accepted. indifference. What is a mixed message? Inconsistency between the verbal and nonverbal components 8. What is the single most important source of nonverbal communication? Facial expressions 10. and impatience. unshared language (shared meaning? Text/Lecture discrepancy) 6. . among other things. What can hand gestures communicate? What can foot shuffling and fidgeting express? Hand gestures = anxiety. What are neologisms? Private. What is kinesics? The study of body movement as a form of nonverbal communication 9. What is subculture? Culture within the culture 4. The eye and brain constantly being tricked into seeing things that are not really what they seem 3. Averting the eyes signals a rejection of the looker's request. What are several common but unstated rules about eye contact? • Interaction is invited by staring at another person on the other side of the room.

social and public distance ranges? Intimate Distance = Close: 0" to 6" Far: 6" to 18" Personal Distance = Close: 1 ½' to 2' Far: 2' to 4' Social Distance = Close: 4' to 7' Far: 7' to 12' Public Distance = 12' to 25' and beyond 15. • If the usual short. 16. glasses. the person looked at is likely to believe that the person gazing considers the relationship between the two people to be more important than the content of the conversation. What are the intimate. True. hairpieces. • Greater mutual eye contact occurs among friends. 17. wedding bands. • A person's frank gaze is widely interpreted as positive regard. What is territoriality? Fixed and permanent territory that is somehow marked off and defended from intrusion 14. What are cultural artifacts? Clothes. 18. etc. piercings. True. personal. True or False: People with schizophrenia can't smell good smells and can't differ body language. perfume. True or False: Schizophrenics need 2x the space others need (6 feet) of they become upset. What are 6 different ways in which verbal and nonverbal systems interrelate? • Nonverbal can repeat verbal – "The fish was huge" and hands show size • Nonverbal may contradict verbal – Sarcasm in voice can contradict what is being said . They describe who we are and what we're about. intermittent gazes during a conversation are replaced by gazes of longer duration. 12. • People who seek eye contact while speaking are usually perceived as believable and earnest. wigs. What is proxemics? The study of space relationships maintained by people in social interaction 13. cosmetics.

Public = such as communication through the mass media or giving a public speech. Explain the speech circuit in Wernicke's and Broca's area. this message becomes an environmental event or stimulus for the first person. Covert Rehearsal = the person moves to make sense of the input received and develops and organizes a message before generating it. Differentiate between intrapersonal. and from there to Broca's area in the left . toward some goal that requires engaging in a social interaction with another. interpersonal and public communication. 21. what should you go with? Nonverbal communication 20. What are the five phases in each person's communication sequence? Input = the person is motivated through some stimulus. There is a speech circuit in the brain between the auditory cortex on the left. which passes to Wernicke's area in the temporal cortex. Message Generation = the instrumental act of giving a message is performed. A message generated by one person serves as the input or the stimulus for another person. Environmental Event = Once the second person completes the covert rehearsal and generates a message. either external or internal. Goal response = Response given from environmental event. when to stop • " May substitute for words – waving hello instead of verbalizing it 19. • " May add to or modify verbal – A man says he's a "little" mad but tone shows a more profound anger • " May accent or emphasize verbal cues – shrugging shoulders when stating "I don't care" • " May regulate – tell people when to speak. If nonverbal communication contradicts verbal communication. 22. Intrapersonal = occurs when people communicate within themselves Interpersonal = takes place in dyads (groups of two people) and small groups.

or access. 24. the emotions of the sender. in which information is conveyed. What are the content levels and the relationship levels of communication? Content levels = the report aspect. Feedback = The process by which performance is checked and malfunctions corrected. clarity. Kinesthetic . Visual. maximize difference between partners 28. 26. What is tangential reply? Disregards the content of the message and is directed toward either and incidental aspect of the initial statement. Relationship levels = communication about communication. What are the three sensory modalities that Bandler and Grinder conclude how people take in. It performs a regulatory function in the communication process. 27. the partners usually mirror each other's behavior Complementary = based on difference. and correct timing. or another facet of the same topic. information? Auditory. What are the four formal criteria for successful communication? Efficiency = Simplicity. 25. Appropriateness = Messages are appropriate when they are relevant to the situation at hand and when there is mutual fit overall patterns and constituent parts. Flexibility = People cannot always be sure how a message will be received. Underload occurs when delay or lack of information interferes with a person's ability to comprehend the message of another. What is overload vs. What is the difference between symmetric and complementary relationships? Symmetric = based on equality. underload? Exceeding a tolerance level is called overload. frontal lobe via the arcuate fasciculus (a pathway composed mainly of axons that synapse with other neurons). 23. the type of language used. because each person with whom they communicate is unique and changing.

33. What is the therapeutic nurse-client relationship ("one-to-one" relationship)? . Practice. 32. speech pattern and voice tones 31. Respond with empathy. Use facial. respect. one must identify what things first? Preferred predicates. they assume that there is a parallel between their feelings and those of the client. concern with self. visual or kinesthetic. eye-accessing cues. What is the difference between empathy and sympathy? Empathy contains no elements of condolence. gross hand movements. and body gestures judiciously. immediacy and warm. filtering out 35. Get feedback on your nonverbal communication. Where does anxiety come from? Unmet expectations 30. agreement. breathing pattern. identifying with own memories. judging. What are some blocks to mindful listening (active listening)? Rehearing. 34. or pity. To determine whether a client's representational system or sensory modality is auditory. What are guidelines for improving nonverbal communication? Relax. assuming. getting off track. genuineness. Name 6 interpersonal principles and practices that are essential to facilitating intimacy. When nurses sympathize rather than empathize. Respect client's right to maintains distance. What are common mistakes made in communication? Giving advice = Discounts ability for client to figure out what's best for themselves Minimizing feelings = Makes them think their feelings are irrelevant or not as big of a deal Deflecting = Using humor to avoid present situation Interrogating = Feel more like a prisoner than a patient Sparring = besting the client Chapter 29 1. hand. 29.

Negotiate contract. Mutually defined – both enter voluntarily Collaborative – goals. role of nurse. One in which the nurse uses theoretical understandings. Address confidentiality. consistency. Explore response patterns. Transfer dependence to other support units. independent identity. Forces that inhibit changes. It helps client change habitual response patters. and work of client. and outcomes evolve and are met together . Analyze conflict resolution. expertise and time. achieve treatment goals. 3. What are the three distinct phases of a one-to-one relationship? Explain each. What are important termination tasks? Help client evaluate contract and experience. Working (middle) phase: characterized by the maintenance and analysis of contact. 2. Clarify purpose of relationship. personal attributes. 5. Facility assessment of growing and staying-put. more effective defense mechanisms. and countertransference on part of nurse. Participate in explicit therapeutic good-bye. 4. What are characteristics of the one-to-one relationship? Professional Informal = spontaneous set of interactions Formal = Planning. resistance of client (uncontrollable). Permit testing new behaviors. Analysis of contact (how client relates to others as manifested in nurse-patient relationship). Termination (end) phase: characterized by the termination of contact with the client. Help cope with anxiety. strategies. coping strategies. and appropriate clinical techniques to provide the opportunity for a corrective emotional experience for clients. structure. Occurs when client has relief from presenting problem. What is the therapeutic alliance? A conscious relationship between a facilitative person and a client. Orientation (beginning) phase: characterized by the establishment of contact with the client. improve social functioning.

and thoughts. fantasies. NOT against the nurse. and this serves as a basis for establishing more extensive psychosocial goals. . erotic. as a result of the failure of empathy on the part of the nurse or therapist 8. Most often occurs as the client begins to address self-defeating thoughts. Rather than verbalizing conflicts or feelings. What is acting out? A particularly destructive form of resistance in which the client puts into action (that is. What is resistance? Refers to all the phenomena that interfere with and disrupt the smooth flow of feelings. Look for evidence of transference phenomena toward the nurse. consider withdrawing from the relationship unless the client sets limits on these behaviors 10. Increase frequency of contact. With repeated dangerous acting out. Encourage identification of feelings before putting them into action. What are important nursing interventions relating to acting out? Bring acting out to the attention of the client. What are the five different forms in which resistance is usually expressed? Resistance to the recognition of feelings. The nurse who manifests parental. as the client's reluctance to change behavior outside the nurse-client relationship. memories. as a way of demonstrating self-sufficiency. to revealing feelings toward the nurse or therapist. Goal-directed – Initial goal is to solve an immediate problem. 9. the client displays inappropriate behaviors. Encourage the client to talk about impulses rather than to act them out. sexual or hostile nonverbal behaviors can also be acting out. "acts out") emotional conflicts – externalizing an inner conflict. Client struggling against anxiety that goes with change. feelings and behaviors. 7. and motives. Open – shared dignity Negotiated – client is an active decision maker and is personally accountable Committed – based on the therapeutic contract between nurse and client 6.

True Chapter 8 1. and it is best to avoid unplanned physical contact without therapeutic rationale. causing a negative effect. 12. What is conflict? . Examples include: • Placing hands on hips or pointing a finger while setting limits on a client's behavior (parental) • Patting a client on the shoulder and offering reassurance (parental) • Dressing suggestively (erotic) • Blushing and giggling when a client makes a sexual remark (sexual) • Being sarcastic in response to a client's concern (hostile) 11. True or False: You should not take from or give gifts to clients. True or False: The caretaker role tends to involve empathy rather than sympathy. The caretaker role tends to involve sympathy rather than empathy. This encourages acting out of the client. feelings. countertransference? *Both are normal but can inhibit the relationship. Should be avoided in therapy though. The internal state the stress produces is one of: Tension. What is stress? A demanding situation taxes a person's resources or coping capabilities. False. What is a stressor? The source of the stress. A person-environment interaction 2. The nurse could develop powerful counterproductive fantasies. and attitudes in response to the client's transference or personality. Should avoid the caretaker role in which you relieve the pain. anxiety or strain 4. 13. Could be positive or negative. the demanding situation 3. Countertransference = the nurse's response to the client.* Transference = A set of feelings and thoughts about significant others in the client's past and current life that is transferred to the caregiver. What is transference vs.

weight loss. anxious. Not necessarily harmful. spleen. aches and pains in muscles and joints. 5. Symptoms = ↑ HR. What are the 4 steps of how a conflict proceeds? • The person holds two goals simultaneously. What is the fight-or-flight response? What are symptoms? Fight (aggression) or Flight (withdrawal). Selye defined stress as the rate of wear and tear on the body. or emotional. developmental. or goals – often explains such behaviors as hesitation. Actual body damage = enlargement of the adrenal glands. BP. 10. What is Selye's Stress-Adaption Theory? According to Selye. • The person moves in relation to both of the goals using (a) approach-avoidance movements or (b) avoidance- avoidance movements • The person shows hesitation. each person has a limited amount of energy to use in dealing with stress. Stressors can be physical. vacillation. blocking. What conflicts are the most likely to cause stress? • Conflicts that involve social relations with significant people • Conflicts that involve ethical standards • Conflicts that involve meeting unconscious needs • Conflicts that involve the problem of everyday family living 6. (Panic attack) 9. physiologic. Having opposing desires. . and lymph nodes. and the appearance of bleeding gastric ulcers. BG. Pupil Dilation. shrinkage of the thymus. and diaphoresis. Dry Mouth. blocking. and fatigue. 7. chemical. • Resolution occurs either temporarily or permanently. feelings. RR. felt/looked ill. or fatigue. What symptoms did Selye observe that all sick people have in common? Loss of appetite. vacillation. fatigue. Adrenaline rush response to excessive stress. What is vacillation? Moving first one way and then another 8.

17. Coping: The person applies the coping resources and options at his or her disposal. Reappraisal: Person engages in ongoing reinterpretation of the situation based on new info. What is the general adaption syndrome (GAS)? Structural and chemical changes produced in the body that can be objectively measured. What is Psychoneuroimmunology (PNI)? Interaction among the neurological. loss. the whole person must adjust to the changes. Not all people receive stress in the same way 14. harm. 12. What is cognitive appraisal? Once a person has perceived a threat. It is called this because when stress affects the whole person. 15. Secondary appraisal: The person evaluates his or her coping resources and options in the situation. True or false: All people receive stress in the same way False.11. and immune systems and takes into account the nature of the influence . What are the 3 stages of GAS? Alarm: "Fight or Flight" Immediate short-term responses to crises Resistance: Long-term metabolic adjustments occur Exhaustion: Collapse of vital systems 13. 16. Perceived threat—what the person appraises as taxing or exceeding his or her resources and endangering his or her well-being— is the central characteristic of stressful situations because it threatens a person's most important goals and values. endocrine. How did Lazarus view stress? (De Niro studied him a lot in school! Possible test questions on him!) Known for his transaction-based approach to understanding stress. the person evaluates it by thinking about it. Stress is a process of complex interplay among the perceived demands of the environment and the perceived resources one has for meeting these demands. threat or challenge in a situation. How does the process of cognitive appraisal work? Primary appraisal: The person assesses the potential for benefit.

and disease-prone personalities. Suspicious of others. vasoconstriction. Differentiate between mild. and grasps less. Hardiness: People with confidence in ability to control circumstances and commitment to demands of life have fewer illnesses. With direction. . angry or depressed. Disease-prone: Display negative emotions. New stimuli may be overwhelming and cause anxiety levels to rise even higher. The person sees. RR. Often described as a feeling of terror or dread. Activate sympathetic nervous system. secure. Enthusiastic. Can be constructive or destructive. BP. Person shuts out the events on the periphery while focusing on central concerns (selective inattention). this person can focus on what they have previously shut out. but the perceptual field narrows. The sympathetic nervous system is activated in severe anxiety. of psychosocial factors on immune function and health outcomes 18. Likable. Self-healing: Emotionally stable people who bounce back from stress. Moderate: Person remains alert. epinephrine secretion. close warm relationships. Difficulty in problem solving. The person feels relatively safe and comfortable. 19. Mild: Helps one deal constructively with stress. most uncomfortable feeling a person can experience. but there is an element of voluntary control. increase cortisol (increase weight and stress) and suppresses immune system. Focus on small or scattered details of an experience. Differentiate between self-healing personalities. joyful. severe anxiety and Panic persons. What is anxiety? A state of varying degrees of uneasiness or discomfort. energetic. and content. hardiness. moderate. A mildly anxious person has a broad perceptual field because it heightens the ability to take in stimuli. Severe: Sensory reception is greatly reduced. anxious. hears. Neurology = dysregulation in GABA 20. alert. "Great educator" – mild anxiety helps clients learn. Reduced ability to organize. and Body temperature. causing an increase in HR.

What are coping strategies? A set of behaviors people under stress use in struggling to improve their situations. meditation. Disintegration of the personality experienced as intense terror. Avoidance and Withdrawal = No sleep or a lot of sleep. Unable to initiate or maintain goal- directed action. Behavior may appear purposeless. What are some ways people cope with stress? Seek comfort = gentle touch. 22. Would teaching be an effective nursing intervention for a client with severe anxiety? No. or distorted. it would be pointless due to reasons listed above. 24. swearing. Peplau believed that all psychosis preceded by panic. Details may be enlarged. and communication may be unintelligible. Self-discipline = Laugh off. and relaxation exercises . Working it off = Physical activity. Such behavior becomes harmful only when it is the predominant means of coping with stress. Panic: Characterized by a completely disrupted perceptual field. focusing more on career Self-healing practices = Yoga. Logical thinking and effective decision-making may be impossible. such as illness and hospitalization? Explain. stiff upper lip. What are the two general reactions/behaviors to threatening situations. and laughing all tend to relieve tension. 21. scattered. visualization. bite the bullet. massage. Task-oriented: When we feel competent to deal with stress and the situation is not too threatening to our sense of self. get over it – don't want support Intense expression of feelings = crying. 23. Defense-oriented: When we feel inadequate to cope with stress and the situation is extremely threatening to our sense of self. Geared toward problem solving. love. substances and food. Talking it out = established/maintains contact with others and allows for new ideas Privately thinking it through = Become introspective about it.

Spirituality/Prayerfulness = Connection with others. or organization that help in managing tensions Physical/Biochemical GRRs: Physiologic characteristics (genetic features & levels of immunity) Artifactual/Material GRRs: Material goods and relative wealth Cognitive GRRs: Intelligence and knowledge Emotional GRRs: People who are self-aware Valuative/Attitudinal GRRs: Products of a person's culture and environment. annual income. and/or a Supreme Being. Accurate appraisal and flexible approach is in regards to attitudinal. blushing. physical appearance Somatizing = "Organ Language" Going into physical s/s (Palpitations. Define 12 different types of defense mechanisms: Denial: Blocking out painful or anxiety-inducing events or feelings . nature. Symbolic substitutes = confession. What are generalized resistance resources (GRRs)? Give examples. inflexible coping pattern. etc. Factors in the person.) 25. Mostly unconscious. sacrifice. group. 28. Really self-deceptions.) that facilitate coping 27. A sense of coherence comes about when a person has what 3 attributes? Comprehensibility = the ability to understand the things that happen in life (the cognitive or thinking aspect of coherence) Manageability = having trust that things will work out well because one has the resources to meet demands (the behavioral or action aspect of coherence) Meaningfulness = the motivation to invest time and energy in life's challenges (the feeling aspect of coherence) 26. Interpersonal-Relational GRRs: Available social support systems Macrosociocultural GRRs: Institutional structures (ceremonies/rites/etc. prayer. sweating. What are defense mechanisms? Using mental mechanisms to lessen anxiety and prevent pain regardless of cost.

urgent. Hostility. pectoris. What are causes of peptic ulcer disease (PUD) and emotions associated with it? Stressful lifestyle of trying to be "getting ahead". by a temporary alteration of consciousness or identity Fantasy: Symbolic satisfaction of wishes through nonrational thought Identification: Unconscious assumption of similarity between oneself and another Intellectualization: Separating an emotion from an idea or though because the emotional reaction is too painful to be acknowledged. hostile. angina. Asthmatic people may feel: . impatient. and what medical conditions correlate? Highly competitive. Displacement: Discharging pent-up feelings on people less dangerous than those who initially aroused the emotion Dissociation: Handling emotion conflicts. Introjection: Acceptance of another's values and opinions as one's own Projection: Attributing one's own unacceptable feelings and thoughts to others Rationalization: Falsification of experience through the construction of logical or socially approved explanations of behavior Reaction formation: Unacceptable feelings disguised by repression of the real feeling and by reinforcement of the opposite feeling Repression: Unconsciously keeping unacceptable feelings out of awareness Suppression: Consciously keeping unacceptable feelings and thoughts out of awareness 29. What medical condition correlates with compulsive personality? Inflammatory bowel disorders 31. irritability. and impaired coping ability. or internal or external stressors. CV disorders (CAD. 32. hypersensitivity. What are characteristics of type A personality. and myocardial infarction) 30. and driving.

• The meaning of things in a person’s life is derived from the social interactions that person has with others. It is very common for emotional tension to result in a: Headache 35. What is the Medical-Psychobiological Theory? Mental illness viewed like any physical disease (due to toxins. 3. biochemical abnormality or genetic predisposition). events) based on the meaning that the things have for them. Must note social and cultural environment of each client. We learn meanings during our experience with others. Life experiences may have different meaning for different people. urticaria. 2. People with Rheumatoid Arthritis (RA) are described as: Self-sacrificing. the feed-back loop has long been accepted as the model for the functioning of: Endocrine organs 36. Can be summarized with the following attributes: • The individual suffering from emotional disturbances is sick and has an illness or defect . Helpless and vulnerable 33. In physical medicine. and perfectionistic 34. masochistic. excessive sweating (hidrosis). inhibited. They come to their own conclusions. ALL behavior has meaning. What are psychophysiologic conditions associated with skin disorders? Itching (pruritus). What is symbolic interaction? An approach to the study of human conduct based on three philosophic premises: • Humans act toward things (other people. What is humanism? A theory of life centered on human beings. and atopic dermatitis Chapter 5 1. Nurse must identify meanings actions have for clients. • People handle and modify the meanings of the things they encounter through an interpretive process.

be located in some part of the body (usually the brain’s limbic system and the central nervous system’s synapse receptor sites). chemicals. 4. including drugs. 6. psychosis. however obscure. comments made while drunk. Thus. Each psychic event is determined by ones that preceded it. and can discourage claims that mental disorders result from a lack of willpower or moral character. Accidents are caused by wish of person. 2. who believed all psychological and emotional events. and dreams bear relationship to the rest of the person’s life. dreams. What is psychoanalysis? A method for studying the unconscious. at least presumably. the client e experienced a neurotic conflict. biochemical. Role of the unconscious are seen through: Slips of the tongue “Freudian slip”. 5. What is Psychic determination? No human behavior is accidental. • Psychobiological explanations of mental disorders reduce the stigma often associated with them. are understandable. • Mental disorders respond to physical or somatic treatments. What is the Psychoanalytical Theory? Credited to Freud. alterations in the body’s biologic rhythms.) The incompatible idea and the neurotic conflict . He believed that childhood experiences caused adult neuroses. The basic logic behind it is that 1.) The client underwent a traumatic experience that stirred up intense and painful emotion. • The illness can. and mental symptoms that can be diagnosed/classified/labeled. Factors related to mental disorders include excesses or deficiencies of certain brain neurotransmitters. 7. • Mental diseases run a characteristic course and have particular prognosis for recovery.) The traumatic experience represented to the client some ideas that incompatible with the dominant idea constituting the ego. and genetic predisposition • Illness has characteristic structural. hormones. 3. diet. including the sleep-wake cycle. or surgery.

Differentiate between id. What are the 2 types of drives? Sexual and aggression 10. imposing demands in the form of conscience or guilt feelings. 8. Channeling Reemerging sexuality . Primitive drives. ego and superego. Genit 12 years. the symptoms disappear. Phalli 3-6 years Gender Repression of attraction c identification and to the opposite-sex genital awareness. One of its fundamental functions is also the capacity for developing mutually satisfying relationships with others. A baby is all id. Reality based. leading to same-sex identification. Superego = Concerned with moral behavior. Operates on pleasure principle – seek pleasure. resolved with a shift to other interests and friends. avoid pain. parent. and. Frequently.) Therapy is directed toward resolving the conflict by uncovering its roots in the unconscious. through defense mechanisms. oral activity.Learning muscle Delayed gratification 3 years control for toilet and rule internalization. Ego = controls action and perception. Laten 6-12 years Repression of Oedipal conflict cy sexuality. associated with it force the ego to bring into action defense mechanisms. Anal 18 months. 9. training. the superego allies itself with the ego against the id. controls contact with reality. If the client is able to release the repressed feelings associated with the conflict. What are Freud’s psychosexual stages? Stag Age Span Task Key Concept e Oral 0-18 Satisfaction and Oral activity gives months anxiety pleasure and is a management from source for learning. Id = completely unorganized reservoir of energy derived from drives and instincts. inhibits primary instinctual drives. 4. demand immediate satisfaction.

What is shaping? The term for an intervention designed to change a person's behavior and bring the person closer to the desired behavior 16. negative reinforcement? Behaviors are rewarded and persist. What is positive punishment vs. negative punishment? Positive punishment: Decrease the behavior by adding aversive consequences Negative punishment: Decrease the behavior by either drawing a reinforcer or reward. so that the response occurs in reaction to the new stimulus alone. 11.) A response is a reaction to a stimulus 2. What is cognitive behavior theory? Focuses on the present rather than the past. The basic principle of the conditioned response is 1. Best research and most effective out of all the therapies. What is token economy? Clients are rewarded for desired behavior by token reinforcers. the same response reaction can be obtained 3. Negative reinforcement: An event that is likely to decrease the possibility of recurrence because it penalizes the behavior. Positive reinforcement: An event that increases the probability that the response will recur—a reward for behavior. 15. What is a conditioned response? Famous experiment with a dog and a bell. adult relationships with members of the opposite sex. young sexuality into to motivate behavior. What is interpersonal theory? . 12. What is reinforcement? What is positive vs. 17. such as food. 14. 13. Began with Pavolv's conditioned responses. and verbal approval.) If a new and different stimulus is presented with or just before the original stimulating event.) Eventually the new stimulus can replace the original one.

companionship. or hierarchy. Provides tools that enable people to deal with the tasks of avoiding anxiety and establishing security. 19. success at work. (People need approval from others to protect against anxiety. willfulness . order. Lower level needs must be met before higher level. withdrawal and estrangement 18 Early Autonomy vs. Sullivan said that the patient's relationships are the real focus of psychiatric inquiry. What are self-systems? "Self-dynamism". What is Maslow’s Hierarchy of Needs? An order. defiance. Self Actualization: Fulfillment of unique potential Top Esteem and Recognition: Self-esteem and the respect of others. sleep. and physical safety Physiologic: Biologic need for food. and identification with a group Safety: Avoiding harm. Result of reflected appraisals from significant others. compulsive self-restraint or compliance. oxygen. water. What are Erickson’s 8 Development Stages? Age Stage of Task/Area of Concepts/Basic Developm Resolution Attitudes ent Birth-18 Infancy Trust vs. of basic human needs. years Doubt ability to cooperate and to express oneself. shelter. attaining security. Ability to trust others months Mistrust and a sense of one's own trustworthiness. prestige Love and Belonging: Giving and receiving affection. a sense of hope. The client's past and present relationships with others and modes of interaction. sexual expression Bottom 20. 18. Self-control without months-3 Childhood Shame and loss of self-esteem.

perseverance. self- denial and self- restriction 6-12 School Age Industry vs. Stagnation productivity. some ability to evaluate one's own behavior. Acceptance of the to death Despair worth and uniqueness of one's life. possibly antisocial behavior 18-25 Young Intimacy vs.Realistic sense of Childhood Guilt purpose. feeling that one will never be "any good. withdrawal from school and peers 12-20 Adolescents Identity vs. self- indulgence. concern for others. prejudice 25-65 Adulthood Generativity Creativity. years vs. impersonal relationships.3-5 years Late Initiative vs. Realization of years Inferiority competence. contempt for others . sense of loss. commitment to work and relationships. impoverishment of self 65 years Old Age Integrity vs. Capacity for love as years adulthood Isolation mutual devotion. indecisiveness. plans to actualize one's abilities. feelings of confusion. Coherent sense of years Role Diffusion self.

23. community psychiatry. Compare the major features of traditional psychiatric theories: Theory Assessm Problem Goal Dominant ent Base Stateme Interventions nt Medical. unconscio us Cognitive Behavior Learning Behavior Behavior behavioral Deficit change modification or . psychoeducation. What is the General Systems Theory? What are Menninger's 4 major issues? When applied to living systems (people).) Psychologic regulation and control. 3.) Motivation.) Client include the client system. social change. Menninger's work addresses 4 major issues: 1. What are nursing roles in social-interpersonal theories? What are implications for practice? Case management. provides a conceptual framework for integrating the biologic and social sciences with the physical sciences.) Adjustment or individual- environment interaction 2. 22. 2.) Intervention strategies include primary prevention achieved through psychoeducation. Individual Disease Symptom Psychopharmac psychobio client managem ology and other logic symptom ent.) The organization of living systems 3. and research. 4.) Approach clients in holistic ways (increases the number of factors the nurse must assess). social psychiatry. 21. and milieu therapy Implications = 1. System depends on amount of stress and amount of coping.) Therapy: Helping troubled people gain a useful perspective on their lifestyle and social environment rather than just controlling symptoms. known as ego theory in psychoanalysis 4. cure biologic s therapies Psychoan Intrapsyc Conflict Insight Psychoanalysis alytic hic. which is often called instinct and drive in psychoanalytic framework.

4. 5. schizophrenia. family. 3. What is the global burden of disease? Represents comprehensive estimates of patterns of mortality and disability from diseases and injuries. Acknowledging diversion = first step toward improving one's cultural competencies and understanding. 2. and appreciating the importance of cultural factors in the delivery of health services. bipolar disorder. Interactio Interperso Enhanced Group. providing social belonging and loyalty to a particular reference group within society. 6. What is ethnicity? Refer's to one's sense of identity. What is cultural sensitivity? The process of increasing professional effectiveness through understanding. What is ethnocentrism? The belief that one's own culture values and behaviors are superior and preferable to those of any other cultural group. What is cultural competence? Refers to the capacity of nurses or health service delivery system to effectively understand and plan for the needs of a culturally diverse client or group. respecting. and obsessive compulsive disorder). What are 5 ways to improve cross-cultural communication skills? • Attending multicultural events • Reading about different cultural groups • Talking to members of the cultural group . Interperso ns nal awareness and milieu nal between dysfunctio and therapies individual n quality of and interperso social nal context interaction s Chapter 9 1. alcohol use. conditioning Social. 5 of 10 leading causes of disability are mental health (Unipolar depression.

smoking. and evaluates preventive and therapeutic measures. culture. both old and new. 11. What does psychiatric epidemiology focus on? What is the definition? What are benefits? Human populations. and identifies high risk groups. etc. What is the nurse-as-culture-broker? Serves as a bridge between the client and the providers in the health care system by "stepping in." or intervening. linking. What are age risk factors? Most disorders = 25-44 years old Alcoholism = Early 40s . and behaviors of mainstream U. 12. The study of the distribution and determinants of mental disorders (or other health-related conditions or events) in human populations. What is culture brokering? The act of bridging. present in a population during a specific period of time.S. 13. attitudes. male to female. on the following risk factors: Alcoholism = 6:1 Depression = 1:2 Phobias = 1:2 15. What is acculturation? Degree to which a particular client or group from another culture has adopted the values. What is a risk factor? A factor whose presence is associated with an increased chance or probability of mental disorder (age. What is a prevalence rate? Total number of active cases. • Spending time in a particular ethnic community • Learning another language 7. or mediating between groups of people of different cultural systems to reduce conflict or produce change 9.) 14. What is incidence rate? Measures the number of new cases of a disease or disorder in a population over a specific period of time. Determines causes for specific disorders. What are the gender ratios. 8. to facilitate the acquisition of effective health care 10. not individual clients. Plans for current and future health needs.

What are risk factors on positive family history? Depression and schizophrenia Genetic vulnerability to developing alcoholism Dementia of the Alzheimer's type. health and healing process. What are risk factors for physical environment? Chemical exposure and homelessness = ↑ CNS disturbances/mental disorders 23. 19. use of time. True or False: Higher levels of stress associated with particular events in one's social environment may be associated with increased rates of mental disorders. and anxiety disorders are all being studied in correlation with family history. What are lifestyle habits that should be incorporated in nursing assessments? Dietary patterns. religious and spiritual beliefs. What are risk factors on marital status? Single = psychiatric disorders such as schizophrenia Depression = Highest in divorced/separated Married women > non-married women Married men < non-married men 18. predictive of shortened life expectancy. and migration patterns. True 22. use of alcohol and drugs. What seasons are individuals with schizophrenia most likely to be born in? Winter or Spring 21. bipolar. Drinking with driving/fighting = early 20s 16. . How is ethnicity a risk factor for Depression and Suicide? Depression = Caucasian men > African-American men African-American women > Caucasian women Suicide = Caucasians of all ages > African-Americans Naïve American youth increased risk 17. 20. What are risk factors on physical health status? Psychiatric clients have an increase mortality rate Medically hospitalized have an increased rate of psychiatric disorders Major depression – associated with many chronic medical conditions.

some leave residual impairment or short or long-term disability.Occurring primarily in the southern US and in out (or Caribbean groups. What are culture bound syndromes. but disorder not there Stage of Presymptomatic Disorder: No apparent disorder. either spontaneously or through therapy. they may be considered ordinary discomforts of daily living. among others. May be found in Malaysia. 25. Although the out) person's eyes are open and the person can hear and understand what is occurring. fainting. or homicidal behavior directed toward objects or other people. along with a . The disorder has begun but remains unrecognizable because it is asymptomatic.24. but pathological changes have started to occur. Syndro Description me Amok A dissociative episode characterized by a period of brooding followed by an outburst of violent. and a sense of suffocation. What are the stages of the natural history of disorders? Explain each. aggressive. loss of consciousness. Papua New Guinea. If signs of the disorder are present. Puerto Rico. Stage of Susceptibility: Presence of risk factors that favor the occurrence of disorder. Chronic disability is the most significant. However. weakness. Stage of Clinical Disorder: Recognizable signs and symptoms of disorder Stage of Disability: Run course and resolve completely. these episodes are blacking characterized by a sudden collapse. the person feels powerless to move. Locality-specific patterns of experience—localized folk diagnostic categories that explain repetitive and troubling behaviors to specific societies. Falling. and among Navajo. like mild depression. Give examples. Ghost Various symptoms such as nightmares. sickness feelings of impending doom. hallucinations. the Philippines. Polynesia. Laos.

Children are especially at risk. frequent dreams. masturbation. and nocturnal emission. Excessive semen loss is feared because it represents the loss of vital essence and can be seen as life threatening. and sexual dysfunction (such as erectile dysfunction and premature ejaculation). It includes a wide range of symptoms of emotional and somatic disturbance and refers to a general state of vulnerability to stressful life experiences. this condition has also been found in Siberian groups." Common in ojo other Mediterranean cultures. diarrhea. crying without apparent cause. the parrot-like repetition of a word or phrase just spoken by another (echolalia). Latah This syndrome is characterized by hypersensitivity to sudden fright. and trance-like or dissociative behavior. and Japan. Other ethnic groups (such as nevra among the Greeks) have similar ideas about "nerves. their symptoms include fitful sleep. Originally of Malaysian or Indonesian origin." Shenkui In China and Taiwan. common among Latinos in North America and Latin America. this folk label describes marked anxiety or panic symptoms accompanied by somatic complaints. It is attributed to excess semen loss through frequent intercourse. and fever." it is . Also known as "loss souls. preoccupation with death are associated with the deceased and sometimes with witchcraft. with the automatic repetition by imitation of the movements of another (echopraxia). Mal de This Spanish phrase means "evil eye. command obedience. Nervois A term that means a distress of the nerves. the evil eye can be a curse instituted by an enemy. Susto This folk illness is prevalent among some Latinos in the US and among people in Mexico and Central and South America. vomiting. the Philippines. Thailand.

What are the 3 main obstacles to improved mental health/getting care? 1. and homeless persons. who prescribe the majority of psychotropic medications. feelings of diminished self-worth. 27. 3. • Comorbidity increases the likelihood that a person will seek treatment. troubled sleep. feeling of sadness. Who are the severely underserved groups in relation to mental health services? Substance abusers. • Individuals with chronic mental disorders comprise the majority of those who seek treatment. What were some findings on the National Comorbdity Survey (NCS) that are important to know? Women = Higher rates of affective and anxiety disorders Men = Higher rates of Substance Abuse and Antisocial Personality disorders. 30. resulting in unhappiness and sickness including appetite disturbances. yet there is a undersupply of psychiatrists in the US. What are common health care-seeking patterns? • Most persons with mental disorders don't seek professional treatment. stomachache. • Psychiatrists tent to treat individuals with severe disorders. headache. older adults (especially if minority). 2. What is comorbidity? The occurrence of two or more psychiatric disorders over and individual's life span. and diarrhea. Most Disorders = ↓ with age and ↑socioeconomic status Most common = depression and alcohol dependence Nearly ½ of 1 of the mental disorders is lifelong 28.) Scarcity of Resources. 29. lack of motivation.) Inefficiencies in the use of resources . uninsured persons. • Most people seek treatment from primary care physicians. thought to be caused by a frightening event that causes the soul to leave the body.) Inequities in the distribution of resources. 26.