Historical Overview of Psychiatric Care

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Questions and Answers

What was a common historical belief about the cause of mental illness in some cultures?

  • Lack of education
  • Dispossession of the soul (correct)
  • Lack of hygiene
  • Genetic inheritance

Which method did Hippocrates suggest to balance the four humors in the body?

  • Meditation practices
  • Magical incantations
  • Inducing vomiting and diarrhea (correct)
  • Hypnotic sessions

How did some cultures historically try to 'cure' mental illness related to spiritual beliefs?

  • Isolation in caves
  • Electric shock therapy
  • Ritualistic exorcism (correct)
  • Herbal remedies

During what period did the association of mental illness with witchcraft prominently prevail in Europe?

<p>Middle Ages (C)</p> Signup and view all the answers

What distinctive concept did Hippocrates contribute to the understanding of mental illness?

<p>Physical cause theories based on body fluids (C)</p> Signup and view all the answers

Which of the following practices was NOT used historically as a 'cure' for mental illness?

<p>Meditative yoga (B)</p> Signup and view all the answers

What was one consequence of associating mental illness with demonology in ancient times?

<p>Executions of affected individuals (D)</p> Signup and view all the answers

What is a main theme explored in the evolution of psychiatric care?

<p>Different cultural adaptations to anxiety and grief (D)</p> Signup and view all the answers

Which characteristic is NOT associated with self-actualized individuals?

<p>Dependency on societal norms (A)</p> Signup and view all the answers

According to Jahoda, which indicator reflects an individual's ability to maintain equilibrium among life processes?

<p>Integration (C)</p> Signup and view all the answers

Which element of Horwitz's definition of mental illness focuses on the cultural norms?

<p>Cultural relativity (C)</p> Signup and view all the answers

What is one indicator of mental health identified by Jahoda that relates to independent behavior?

<p>Autonomy (C)</p> Signup and view all the answers

What characteristic of self-actualization involves an individual's resistance to cultural norms?

<p>Nonconformance (A)</p> Signup and view all the answers

Which indicator suggests that an individual can change and adapt to life's situations?

<p>Environmental mastery (B)</p> Signup and view all the answers

According to the DSM-5-TR, what does a mental disorder reflect?

<p>A disturbance in cognitions, emotion regulation, or behavior (B)</p> Signup and view all the answers

What is an example of a distortion in the perception of reality, according to mental health indicators?

<p>Inability to perceive the environment accurately (B)</p> Signup and view all the answers

Which characteristic of self-actualized individuals involves the capacity for focusing concentration?

<p>Concentration on problem-solving (A)</p> Signup and view all the answers

Which of the following is NOT a characteristic of a democratic character structure?

<p>Dominance over others (D)</p> Signup and view all the answers

What is the new diagnostic category in DSM-5-TR related to grief?

<p>Prolonged grief disorder (D)</p> Signup and view all the answers

What does a positive attitude toward self include?

<p>Acceptance of one's strengths and limitations (B)</p> Signup and view all the answers

What may be considered if there is an absence of mourning after a loss?

<p>Maladaptive behavior (D)</p> Signup and view all the answers

Which concept refers to behavior that is understood within its cultural context?

<p>Cultural relativity (C)</p> Signup and view all the answers

How is 'mental health' defined in terms of stress and adaptation?

<p>As the successful adaptation to stressors (A)</p> Signup and view all the answers

Which of the following is a hallmark of mental illness as defined in the content?

<p>Maladaptive responses interfering with functioning (C)</p> Signup and view all the answers

According to Peplau's levels, what are the stages of anxiety?

<p>Mild, moderate, severe, panic (D)</p> Signup and view all the answers

What does Robinson's definition of mental health emphasize?

<p>Thoughts and feelings that align with local norms (C)</p> Signup and view all the answers

Which aspect distinguishes mental health according to the content?

<p>Congruence with age and cultural norms (B)</p> Signup and view all the answers

What characteristic of self-actualized individuals involves emotional intensity?

<p>Intense emotional reaction (D)</p> Signup and view all the answers

What practice contributed to the expression 'ship of fools' during the period described in the text?

<p>Sending individuals with mental illness to sea alone (B)</p> Signup and view all the answers

What does the Mental Health/Mental Illness Continuum represent?

<p>A range of mental health responses to stress (B)</p> Signup and view all the answers

What is grief described as in terms of loss?

<p>A response to loss of a valued entity (C)</p> Signup and view all the answers

How did Middle Eastern countries during this period perceive mental illness?

<p>As a medical problem (B)</p> Signup and view all the answers

Which symptoms are associated with maladaptive responses to grief?

<p>Risk for clinical depression (D)</p> Signup and view all the answers

What was the primary approach to mental illness care in Colonial America?

<p>Family responsibility (A)</p> Signup and view all the answers

What role did Benjamin Rush play in the history of mental illness treatment?

<p>He was the first to provide humanistic treatment (B)</p> Signup and view all the answers

What influence does culture have on identifying mental illness?

<p>It determines the meaning of behaviors (A)</p> Signup and view all the answers

Why is careful assessment crucial in distinguishing grief responses?

<p>To differentiate between normal and treatable grief responses (A)</p> Signup and view all the answers

What was Dorothea Dix known for in the field of mental health?

<p>Creating state asylums (B)</p> Signup and view all the answers

Which of the following challenges led to a decline in the quality of care in state asylums?

<p>Overcrowding and understaffing (B)</p> Signup and view all the answers

When did the emergence of psychiatric nursing begin?

<p>1873 (D)</p> Signup and view all the answers

What significant change in psychiatric nursing education occurred in 1955?

<p>Incorporation of psychiatric nursing into all undergraduate nursing curricula (D)</p> Signup and view all the answers

What did Maslow's model focus on in terms of mental health?

<p>Individual’s ability to function (A)</p> Signup and view all the answers

What legislation helped to address psychiatric education after World War II?

<p>National Mental Health Act of 1946 (D)</p> Signup and view all the answers

What impact did the introduction of antipsychotic medications have on psychiatric care?

<p>Enabled clients to participate more in treatment (D)</p> Signup and view all the answers

What was a key aspect of Linda Richards' contribution to psychiatric nursing?

<p>Developing a school for psychiatric nursing (C)</p> Signup and view all the answers

How did Dorothea Dix's views differ regarding mental illness in the 19th century?

<p>She believed mental illness was curable (D)</p> Signup and view all the answers

What is a key requirement before achieving self-actualization according to Maslow?

<p>Fulfillment of basic needs (A)</p> Signup and view all the answers

What was a drawback of the early psychiatric asylums despite their humanistic intent?

<p>Harsh medical treatments used (B)</p> Signup and view all the answers

Which level of anxiety is associated with increased motivation and heightened awareness?

<p>Mild (D)</p> Signup and view all the answers

What characterizes severe anxiety in terms of perceptual field and attention span?

<p>Greatly diminished perception and extremely limited attention span (D)</p> Signup and view all the answers

What emotional characteristic is common at the panic level of anxiety?

<p>Sense of impending doom (B)</p> Signup and view all the answers

What is not a characteristic of moderate anxiety?

<p>Total focus on self (C)</p> Signup and view all the answers

How does mild anxiety affect learning?

<p>Learning is enhanced (C)</p> Signup and view all the answers

Which symptom is characteristic of severe anxiety but not panic?

<p>Tachycardia (A)</p> Signup and view all the answers

What is a common characteristic of anxiety as described in the context?

<p>Feelings of uncertainty and helplessness (C)</p> Signup and view all the answers

What is a primary determinant of whether an anxiety response is adaptive or maladaptive?

<p>The degree of interference with functioning (A)</p> Signup and view all the answers

Which of the following is not part of the emotional and behavioral characteristics of moderate anxiety?

<p>Sense of terror (B)</p> Signup and view all the answers

What physiological change is seen in an individual experiencing panic anxiety?

<p>Labored breathing (D)</p> Signup and view all the answers

Which level of anxiety is likely experienced when an individual can no longer comprehend simple directions?

<p>Panic (B)</p> Signup and view all the answers

Which factor is not mentioned as influencing an individual's response to stressful situations?

<p>Cultural background (C)</p> Signup and view all the answers

Which statement accurately describes anxiety at the mild level?

<p>It sharpens senses and increases motivation (D)</p> Signup and view all the answers

What defines the perceptual field in moderate anxiety?

<p>Reduction in perceptual field (B)</p> Signup and view all the answers

What level of anxiety involves being unable to take notice of an event even when directed by another?

<p>Severe (A)</p> Signup and view all the answers

Which of the following is an example of compensation as a defense mechanism?

<p>A physically disabled boy is unable to participate in football, so he compensates by becoming a great scholar. (B)</p> Signup and view all the answers

What happens to the perceptual field as the level of anxiety increases?

<p>It diminishes. (C)</p> Signup and view all the answers

Which coping mechanism is considered more adaptive?

<p>Physical exercise (C)</p> Signup and view all the answers

What term describes behaviors that enhance adaptation to stress?

<p>Coping skills (C)</p> Signup and view all the answers

What is the primary role of the ego according to Sigmund Freud?

<p>To govern problem-solving and rational thinking (B)</p> Signup and view all the answers

Which ego defense mechanism involves attributing one’s unacceptable feelings to another person?

<p>Projection (D)</p> Signup and view all the answers

How does moderate anxiety affect an individual's attention span?

<p>It decreases the attention span. (D)</p> Signup and view all the answers

What kind of disorders can unresolved moderate-to-severe anxiety contribute to?

<p>Physiological disorders (C)</p> Signup and view all the answers

Which defense mechanism involves involuntarily blocking unpleasant experiences?

<p>Repression (C)</p> Signup and view all the answers

Which of the following is an example of intellectualization?

<p>A husband giving logical explanations for his transfer despite anxiety. (A)</p> Signup and view all the answers

What is the defense mechanism characterized by covering up weaknesses by focusing on desirable traits?

<p>Compensation (A)</p> Signup and view all the answers

Which mechanism is used when unacceptable impulses are transferred to a neutral target?

<p>Displacement (D)</p> Signup and view all the answers

In the context of psychological factors affecting medical conditions, what is identified?

<p>Exacerbation of symptoms due to stress (B)</p> Signup and view all the answers

Which defense mechanism involves refusing to acknowledge a real situation?

<p>Denial (C)</p> Signup and view all the answers

What is the effect of unresolved moderate-to-severe anxiety over time?

<p>Contributes to physiological disorders (A)</p> Signup and view all the answers

What is a key characteristic of panic anxiety?

<p>Total loss of reality contact (A)</p> Signup and view all the answers

Which feature is not characteristic of a neurosis?

<p>Severe personality disorganization (C)</p> Signup and view all the answers

In the context of severe anxiety, which of the following symptoms represents a physical manifestation?

<p>Insomnia (D)</p> Signup and view all the answers

What distinguishes sublimation from other defense mechanisms?

<p>Redirecting impulses into constructive activities (C)</p> Signup and view all the answers

What type of disorders are phobias classified under?

<p>Anxiety disorders (B)</p> Signup and view all the answers

Which characteristic is common in psychosis but not in neurosis?

<p>Being unaware of maladaptive behavior (C)</p> Signup and view all the answers

Which term describes the symbolic negation of an intolerable experience?

<p>Undoing (C)</p> Signup and view all the answers

How is severe anxiety different from panic anxiety?

<p>Severe anxiety allows focus on environmental details (D)</p> Signup and view all the answers

Which is an example of a somatic symptom disorder?

<p>Conversion disorder (A)</p> Signup and view all the answers

A mother dedicating her energy to an advocacy group after losing her child is an example of which defense mechanism?

<p>Sublimation (A)</p> Signup and view all the answers

What is not a characteristic of people with psychoses?

<p>Awareness of psychological problems (D)</p> Signup and view all the answers

Which type of disorder involves disruptions in consciousness and perception?

<p>Dissociative disorder (C)</p> Signup and view all the answers

Which statement is true about individuals experiencing grief?

<p>Grief can involve emotional, physical, and social responses. (B)</p> Signup and view all the answers

How does suppression differ from repression?

<p>Suppression is a voluntary process (A)</p> Signup and view all the answers

Which of the following is associated with anosognosia?

<p>Unawareness of psychological problems (C)</p> Signup and view all the answers

Flashcards

Cultural beliefs in mental health

Cultural context influences what is considered acceptable or abnormal behavior.

Ancient treatments for mental illness

Early methods included exorcisms and brutal rituals to expel evil spirits.

Hippocrates' theory

He proposed mental illness resulted from imbalances in the body's humors.

Four body humors

The four humors are blood, black bile, yellow bile, and phlegm.

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Continuum of mental health

Behavioral responses can be seen on a spectrum between mental health and illness.

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Supernatural beliefs

Many cultures attributed mental illness to demon possession or magical forces.

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Psychiatric care evolution

The treatment of mental illness has changed significantly from ancient times to now.

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Witchcraft association

In the Middle Ages, mental illness was often linked to witchcraft, leading to executions.

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Coping Mechanisms

Strategies individuals use to manage mild anxiety in stressful situations.

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Adaptive Coping Skills

Coping behaviors that enhance adaptation, like problem-solving and social support.

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Moderate Anxiety

A level of anxiety where perception diminishes and concentration decreases.

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Ego

The reality component of personality that governs rational thinking and problem-solving.

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Ego Defense Mechanisms

Unconscious protective devices used by the ego to relieve anxiety and protect integrity.

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Compensation

Emphasizing a desirable trait to cover up a weakness or inadequacy.

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Denial

Refusing to acknowledge a real situation or associated feelings.

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Displacement

Transferring feelings from one target to a less threatening one.

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Intellectualization

Avoiding emotional expression by using logic and reasoning.

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Regression

Retreating to earlier developmental behaviors under stress.

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Repression

Involuntarily blocking unpleasant feelings or memories from awareness.

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Projection

Attributing unacceptable feelings to another person.

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Rationalization

Making excuses or logical reasons to justify unacceptable feelings.

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Isolation

Separating thoughts or memories from their emotional tone.

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Reaction Formation

Expressing the opposite of unacceptable thoughts or feelings.

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Maladaptive Responses

Responses to stress that are ineffective and interfere with functioning.

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Adaptation to Stress

The process of adjusting to stressors from the environment.

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Anxiety

A feeling of discomfort due to fear and uncertainty.

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Components of Stress Response

Physiological factors, perception, and predisposing factors influence stress response.

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Four Levels of Anxiety

Mild, moderate, severe, and panic define the intensity of anxiety.

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Mild Anxiety

Heightened perception that increases motivation and learning.

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Severe Anxiety

Diminished perception and inability to concentrate, leading to physical symptoms.

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Panic Anxiety

Complete inability to focus, often leading to bizarre or frantic behavior.

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Physiological Factors

Body responses that influence how we perceive and react to stress.

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Coping Strategies

Methods used to manage stress and anxiety.

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Support Systems

Networks of people who provide emotional and practical help.

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Emotional Responses to Stress

Feelings such as anxiety and grief that can arise from stress.

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Behavioral Responses to Stress

Actions taken in response to stress, which can be adaptive or maladaptive.

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Predisposing Factors

Personal traits and experiences that influence stress responses.

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Normal mourning process

A typical emotional response to loss, including sadness and despair.

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Maladaptive grief

Responses to grief that do not help the individual and may indicate mental illness.

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Prolonged grief disorder

Intense grief lasting over 12 months that impacts functioning, added to DSM-5-TR.

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Grief vs. depression

Grief can lead to clinical depression if responses are maladaptive.

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Mental health definition

Successful adaptation to stress, aligned with age and culture.

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Mental illness definition

Maladaptive responses that interfere with functioning and diverge from cultural norms.

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Anxiety levels

Anxiety can range from mild to panic, affecting coping mechanisms and responses.

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Responses to stress

Anxiety and grief are primary emotional responses to stressors.

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Sociocultural perspective

Behavior may be labeled as mental illness if it's incomprehensible across cultures.

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Normal vs. maladaptive grief

Normal grief is adaptive; maladaptive grief needs assessment for treatment.

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Ship of Fools

A historical practice where mentally ill individuals were set to sea alone in boats to search for rationality.

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First Asylums

Specialized hospital units and institutions for mental illness established in the Middle East.

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Benjamin Rush

Often regarded as the father of American psychiatry; he initiated humane treatment at the first mental hospital in America.

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Dorothea Dix

A reformer who advocated for improved conditions and humane treatment of the mentally ill in the 19th century.

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Custodial Care

A type of care focused on supervision and basic needs, often in overcrowded state hospitals.

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Linda Richards

The first American psychiatric nurse, instrumental in psychiatric hospital establishment and nursing education.

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National Mental Health Act

1946 legislation that funded education for mental health professionals and improved services.

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Hierarchy of Needs

Maslow's model that prioritizes human needs from basic to self-actualization.

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Self-Actualization

The fulfillment of one's highest potential according to Maslow's hierarchy.

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Psychiatric Nursing

A nursing specialty focusing on the care of patients with mental illness.

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Antipsychotic Medications

Medications that help manage symptoms of psychoses, enabling participation in treatment.

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Mental Health Theorists

Individuals who have sought to define and explain the concept of mental health.

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Community Health Movement

A 1960s initiative aimed at improving mental health care and shifting focus from institutions to communities.

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Psychological Therapies

Treatment modalities focused on improving mental health through psychological understanding.

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Self-Actualized Individuals

Individuals who realize their full potential and possess specific qualities, such as independence and creativity.

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Characteristics of Self-Actualization

Self-actualized individuals have spontaneous behavior, problem-solving focus, and a democratic character structure.

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Indicators of Mental Health

Reflective traits including self-acceptance, growth, integration, autonomy, reality perception, and environmental mastery.

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Positive Attitude Toward Self

An objective awareness of one's strengths and weaknesses, leading to personal identity and security.

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Growth and Self-Actualization

The ability to progress towards achieving one's potential and fulfilling developmental tasks.

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Integration

Maintaining balance across various aspects of life, adapting to the environment.

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Autonomy

The capacity to be self-directed, make independent choices, and take responsibility for outcomes.

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Accurate Reality Perception

Seeing the world without distortion, includes empathy and understanding societal norms.

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Environmental Mastery

The ability to effectively navigate and have a satisfying role in society or one’s environment.

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Incomprehensibility in Mental Illness

The inability to understand an individual's motivation behind behavior, leading to mental illness labels.

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Cultural Relativity

The concept that understanding of normalcy varies between cultures; behavior perceived as abnormal in one may be normal in another.

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APA Definition of Mental Disorder

Clinically significant disturbances in cognitive, emotional, or behavioral functioning indicating mental disturbance.

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Successful Adaptation to Stressors

A sign of mental health; adjusting thoughts, feelings, and behaviors to manage stress appropriately.

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Sublimation

Rechanneling unacceptable drives into constructive activities.

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Suppression

Voluntary blocking of unpleasant feelings from awareness.

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Undoing

Symbolically negating an intolerable experience.

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Neurosis

Psychiatric disturbance with excessive anxiety and maladaptive behaviors.

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Anxiety Disorders

Disorders featuring anxiety symptoms and avoidance behavior.

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Somatic Symptoms

Distressing physical symptoms with no organic cause, influenced by psychology.

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Dissociative Disorders

Disruption in functions like consciousness or identity perception.

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Psychosis

Significant thought disturbance with impaired reality testing.

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Grief

Subjective sorrow and responses to the loss of a loved one or thing.

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Mourning

Period of characteristic emotions and behaviors after a loss.

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Repressed Anxiety Effects

Extended periods of anxiety leading to neurotic behaviors.

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Loss Response

Individual's reaction to a perceived or real loss.

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Study Notes

Historical Overview of Psychiatric Care

  • Primitive cultures often attributed mental illness to spiritual or supernatural causes, leading to brutal treatments like exorcism.
  • Hippocrates (400 BCE) moved away from supernatural explanations, proposing that mental illness stemmed from an imbalance of bodily fluids (humors).
  • The Middle Ages saw continued association of mental illness with witchcraft, resulting in practices like sending individuals to sea (ship of fools).
  • Middle Eastern cultures viewed mental illness as a medical condition, eventually leading to specialized institutions (early asylums).
  • Colonial America reflected European attitudes toward mental illness.
  • The 18th century saw the introduction of humanistic treatments in American hospitals.
  • The 19th century saw the establishment of state asylums, though overcrowding and poor conditions arose.
  • 1873 marked the beginning of psychiatric nursing with Linda Richards, who established the first school of psychiatric nursing.
  • The National Mental Health Act of 1946, prompted by post-WWII needs, funded psychiatric education and research.
  • Antipsychotic medications emerged, allowing for greater client participation in treatment.

Mental Health

  • Mental health is defined as successful adaptation to internal/external stressors, demonstrated by age-appropriate, culturally-normative thoughts, feelings, and behaviors.
  • Maslow (1970) proposed a hierarchy of needs, with self-actualization representing the highest level.
  • Jahoda (1958) highlighted six key indicators of mental health: positive self-attitude, growth and development, integration, autonomy, reality perception, and environmental mastery.
  • Robinson (1983) defined mental health as a dynamic state of age-appropriate, culturally-congruent thoughts, feelings, and behaviors.

Mental Illness

  • Defining mental illness universally is challenging due to cultural variations.
  • Horwitz (2010) highlighted incomprehensibility and cultural relativity: behavior deemed abnormal in one culture can be normal in another.
  • The APA's DSM-5-TR defines mental disorder as a syndrome with clinically significant disturbance in cognitions, emotion regulation or behavior, reflecting dysfunction in underlying processes.
  • Mental illness is considered maladaptive responses to internal/external stressors, incongruent to cultural norms and impacting functioning.

Psychological and Behavioral Adaptation to Stress

  • Anxiety and grief are key psychological responses to stress.
  • Adaptation depends on how thoughts, feelings, and behaviors interfere with function.

Anxiety

  • Anxiety is apprehension related to perceived impending danger.
  • Peplau (1963) described four levels: mild, moderate, severe, and panic, each with varying physiological and behavioral characteristics.
  • Coping mechanisms, ego defense mechanisms, and physical/behavioral changes exist throughout these levels.
  • Severe/prolonged anxiety can lead to neurotic symptoms, which can be accompanied by physical problems.
  • Panic anxiety involves extreme misperceptions, loss of reality, and potential for dangerous behavior.

Grief

  • Grief is a subjective response to loss (real or perceived).
  • The normal mourning process includes sadness, guilt, anger, etc., and its absence can be maladaptive.
  • Prolonged grief disorder is a recognized clinical condition in the DSM-5-TR.

Mental Health/Mental Illness Continuum

  • Anxiety and grief are placed on a continuum according to symptom severity, illustrating how maladaptive behaviors exist within a wider spectrum of adaptation.
  • The continuum shows the various levels of severity related to mental disorders and how these behaviors are related to disorders according to the DSM-5-TR.

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