NCM 117 Final: Dissociative Disorders
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Questions and Answers

What is the term used to refer to situational anxiety that resolves itself once the situation is over?

situational anxiety

What are some symptoms of moderate anxiety? (Select all that apply)

  • Sweating (correct)
  • Inability to move or function
  • Stomach pains (correct)
  • Exaggerated hand/arm movements (correct)

    • Severe anxiety includes symptoms such as vomiting and a sense of impending doom.

    True

    Generalized Anxiety Disorder (GAD) involves persistent and excessive worry that interferes with daily activities for at least _ months.

    <p>6</p> Signup and view all the answers

    Match the following symptoms with Panic Disorder:

    <p>Palpitations, pounding heart or rapid heart rate = Panic attacks Numbness or tingling = Panic attacks Fear of losing control = Panic attacks Difficulty concentrating = Generalized Anxiety Disorder (GAD)</p> Signup and view all the answers

    What are compulsions in relation to OCD?

    <p>Repeated actions or thought patterns intended to rid troublesome obsessions</p> Signup and view all the answers

    OCD has a genetic component.

    <p>True</p> Signup and view all the answers

    What is the DSM5 criteria for diagnosing OCD?

    <p>Presence of obsessions, compulsions, or both, with specific characteristics related to each.</p> Signup and view all the answers

    Excoriation Disorder, also known as ______, is categorized as a self-soothing behavior.

    <p>Dermatillomania</p> Signup and view all the answers

    Match the following disorders with their descriptions:

    <p>Body Dysmorphic Disorder = Preoccupation with an imagined defect in physical appearance Onychophagia = Chronic nail-biting behavior Kleptomania = Compulsive stealing behavior Schizophrenia = Chronic brain disorder affecting less than one percent of the U.S. population</p> Signup and view all the answers

    Which of the following are symptoms of dissociative disorders in general? (Select all that apply)

    <p>Blurred sense of identity</p> Signup and view all the answers

    Which of the following are major dissociative disorders? (Select all that apply)

    <p>Depersonalization/Derealization Disorder</p> Signup and view all the answers

    What is the primary symptom of Dissociative Amnesia?

    <p>Memory loss (amnesia)</p> Signup and view all the answers

    Depersonalization/Derealization Disorder is characterized by being detached from one's mental processes or body.

    <p>True</p> Signup and view all the answers

    ______ involves feelings of being detached from one's mind, body, or self, while ______ involves feeling detached from surroundings, where people and things may not seem real.

    <p>Depersonalization, Derealization</p> Signup and view all the answers

    What is the term that refers to a set of symptoms characterized by a loss of touch with reality?

    <p>Psychosis</p> Signup and view all the answers

    Delusions are fixed false beliefs that are based on clear or reasonable evidence.

    <p>False</p> Signup and view all the answers

    What is the most common type of hallucination in schizophrenia?

    <p>auditory hallucinations</p> Signup and view all the answers

    Disorganized thinking and speech refer to thoughts and speech that are jumbled and/or do not make ____.

    <p>sense</p> Signup and view all the answers

    Match the following positive symptoms of schizophrenia with their descriptions:

    <p>Ambivalence = Holding contradictory beliefs or feelings Associated Looseness = Fragmented or poorly related thoughts Delusions = Fixed false beliefs with no basis in reality Echopraxia = Imitation of movements of another person Flight of ideas = Rapid jumping from one topic to another</p> Signup and view all the answers

    What symptoms are involved in schizophreniform disorder?

    <p>Delusions, Hallucinations, Disorganized speech, Grossly disorganized behavior or catatonic behavior, Negative symptoms</p> Signup and view all the answers

    In schizoaffective disorder, individuals experience symptoms of major mood episodes along with symptoms of schizophrenia. How long should delusions or hallucinations be present in the absence of a mood episode for diagnosis?

    <p>At least 2 weeks</p> Signup and view all the answers

    People with schizoaffective disorder experience symptoms of a major mood episode of depression or bipolar disorder at the same time as symptoms of ____________.

    <p>schizophrenia</p> Signup and view all the answers

    Phototherapy, also known as bright light therapy, is used in the treatment of seasonal affective disorder (SAD).

    <p>True</p> Signup and view all the answers

    Study Notes

    Dissociative Disorders

    • Defined by disruptions in consciousness, memory, identity, and environmental perception
    • Interfere with relationships, daily life, and ability to cope with traumatic events
    • Dissociation is a subconscious defense mechanism to protect oneself from recognizing the full effects of a traumatic event

    Symptoms of Dissociative Disorders

    • Memory loss (amnesia) of certain time periods, events, people, and personal information
    • Sense of detachment from oneself and emotions
    • Perception of people and things around them as distorted and unreal
    • Blurred sense of identity
    • Significant stress or problems in relationships, work, or other areas of life
    • Inability to cope with emotional or professional stress
    • Mental health problems, such as depression, anxiety, and suicidal thoughts and behaviors

    3 Major Dissociative Disorders

    • Dissociative Amnesia: inability to remember important personal information, usually of a traumatic or stressful nature
      • Fugue experience: sudden move to a new geographic location with no memory of past events and often assumption of a new identity
      • Three types of amnesia: localized, selective, and generalized
    • Dissociative Identity Disorder (DID): formerly multiple personality disorder
      • Recurrently takes control of behavior, accompanied by inability to recall important personal information
      • "Core" identity is the person's usual personality, and "alters" are alternate personalities
      • Each alter has a particular set of behavior, attitudes, preferences, memories, and ways of thinking
    • Depersonalization/Derealization Disorder
      • Persistent or recurrent feeling of being detached from mental processes or body (depersonalization)
      • A sensation of being in a dream-like state in which the environment seems foggy or unreal (derealization)

    Causes of Dissociative Disorders

    • Not specified

    Treatment of Dissociative Disorders

    • Psychotherapy: cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), hypnosis, and EMDR therapy
    • No specific medications treat dissociative disorders, but medications may be used to treat co-occurring mental health conditions
    • Adjustment Disorder: reaction to a stressful event that causes problems for the individual
    • Acute Stress Disorder: occurs after a traumatic event and is characterized by reexperiencing, avoidance, and hyperarousal

    Nursing Interventions

    • Promote client safety
    • Assess for stressors
    • Explore client's feelings
    • Encourage methods for coping
    • Enhance client's self-esteem

    Anxiety and Anxiety Disorders

    • Anxiety: a normal reaction to stress, but can be beneficial in some situations
    • Anxiety Disorders: characterized by excessive fear or anxiety
    • Types of anxiety disorders: separation anxiety disorder, selective mutism, specific phobia, social anxiety disorder, panic disorder, generalized anxiety disorder, and agoraphobia

    HANS SELYE'S GENERAL ADAPTATION SYNDROME

    • Alarm Reaction Stage: initial symptoms of stress, including the "fight-or-flight" response
    • Resistance Stage: body begins to repair itself, releases a lower amount of cortisol
    • Exhaustion Stage: result of prolonged or chronic stress, characterized by fatigue, burnout, depression, anxiety, and decreased stress tolerance

    Levels of Anxiety

    • Mild Anxiety: close to normal everyday worries and stress, sometimes referred to as situational anxiety
    • Moderate Anxiety: more focused than mild anxiety, with symptoms such as stomach pains, racing heartbeat, and sweating
    • Severe Anxiety: has much of the same symptoms as mild and moderate anxiety, with added symptoms of vomiting, chest pain, and a sense of dread or impending doom
    • Panic Anxiety: the most intense level of anxiety, characterized by an inability to move or function, and a sense of impending doom

    Etiology of Anxiety Disorders

    • Genetic Theories: heritability of anxiety disorders, including panic disorder, social anxiety disorder, and specific phobias
    • Neurochemical Theories: dysfunction of GABA, the body's natural antianxiety agent
    • Psychodynamic Theories: overuse of defense mechanisms, and communication of anxiety to infants or children through inadequate nurturing
    • Interpersonal Theory: caregivers can communicate anxiety to infants or children through inadequate nurturing
    • Behavioral Theory: anxiety is learned through experiences, and people can change or "unlearn" behaviors through new experiences are the study notes for the text:
    • Anxiety Disorders*

    Techniques to Manage Anxiety

    • Thought-stopping and distraction techniques to break the cycle of negative thoughts
    • Techniques include:
      • Splashing face with cold water
      • Snapping a rubber band worn on the wrist
      • Shouting

    Medications

    • For Panic Disorder: BZ's, antihypertensive medications like Clonidine (Catapres) and Propranolol (Inderal)
    • For GAD: Buspirone (Buspar) and SSRI or SNRI

    Behavioral Therapies

    • Systematic desensitization: therapist progressively exposes client to threatening object in a safe setting until anxiety decreases
    • Flooding: rapid desensitization, therapist confronts client with phobic object until anxiety decreases
    • Nursing Interventions*

    For Clients with Anxiety

    • Stay calm and non-threatening
    • Assure client of safety
    • Use simple and clear communication
    • Provide a non-stimulating environment
    • Administer medications as prescribed
    • Recognize precipitating factors
    • Encourage client to verbalize feelings

    Points to Consider

    • Remember that everyone occasionally suffers from stress and anxiety
    • Avoid trying to "fix" the client's problem
    • Discuss uncomfortable feelings with a more experienced nurse
    • Practice techniques to manage stress and anxiety in your own life
    • Obsessive-Compulsive and Related Disorders*

    Definitions

    • Obsessions: recurrent, persistent, intrusive, and unwanted thoughts, images, or impulses that cause marked anxiety or distress
    • Compulsions: ritualistic or repetitive behaviors or mental acts to neutralize anxiety

    Types of Disorders

    • Obsessive-Compulsive Disorder (OCD)
    • Trichotillomania
    • Dermatillomania
    • Hoarding
    • Kleptomania
    • Pyromania
    • Oniomania
    • Body Dysmorphic Disorder

    Etiology

    • Cognitive Theory: thoughts are overly important and need to be controlled
    • Genetics: complex network of genes contribute to OCD risk
    • Behavioral Factors: people who are extremely organized, neat, and meticulous may be at risk
    • Personal Experience: severe trauma can lead to OCD

    Diagnostic Criteria (DSM-5)

    • Presence of obsessions, compulsions, or both
    • Recurrent and persistent thoughts, urges, or images that cause anxiety or distress
    • Attempts to ignore or suppress thoughts, urges, or images
    • Repetitive behaviors or mental acts to neutralize anxiety
    • Related Disorders*
    • Excoriation Disorder (Skin-Picking Disorder)
    • Trichotillomania (Hair-Pulling Disorder)
    • Body Dysmorphic Disorder
    • Hoarding Disorder
    • Kleptomania
    • Oniomania
    • Body Identity Integrity Disorder (BIID)
    • Treatment*
    • Medication: SSRIs
    • Behavioral Therapy:
      • Exposure
      • Response Prevention
      • Deep breathing and relaxation techniques
    • Nursing Interventions for OCD*
    • Offer encouragement, support, and compassion
    • Gradually decrease time for client to carry out ritualistic behaviors
    • Assist client to use "Exposure" and "Response Prevention" techniques
    • Encourage client to manage and tolerate anxiety responses
    • Assist client to complete daily routine and activities within agreed-upon time limits duk

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    Description

    This quiz covers dissociative disorders, which involve disruptions in consciousness, memory, identity, and environmental perception, often as a response to traumatic events. It interferes with daily life and relationships.

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