Foundations of Psychiatric Nursing PDF

Foundations for Psychiatric/Mental Health Nursing Subtopics: Theoretical Models of Personality Development & Concepts of Psychophysiology Bachelor in Nursing Science Program Year 3 Sem 1 AP. Dr Norkiah Arsat Senior lecturer...

Foundations for Psychiatric/Mental Health Nursing Subtopics: Theoretical Models of Personality Development & Concepts of Psychophysiology Bachelor in Nursing Science Program Year 3 Sem 1 AP. Dr Norkiah Arsat Senior lecturer FMHS, Universiti Malaysia Sabah Learning Objectives: By the end of this lecture, students should be able to: 1. Describe the major theoretical models of personality development and their relevance to psychiatric nursing practice. 2. Explain the concepts of psychophysiology and their importance in understanding the biological basis of mental health disorders. 3. Critically evaluate the impact of personality development theories on therapeutic interventions in mental health nursing. 4. Apply psychophysiological concepts to assess and manage patients with psychiatric and mental health disorders.  1. Theoretical Models of Personality Development:  1. Theoretical Models of Personality Development: a. Sigmund Freud's Psychoanalytic Structure of Theory: Personality: Id: The innate, biological component of personality. Operates on the pleasure principle,  Psychosexual Stages of Development: 1. Theoretical Models of Oral Stage (0-1 year): Personality Development o ▪ Pleasure centers on the mouth (sucking, biting). ▪ Issues can lead to oral fixation (smoking, overeating). o Anal Stage (1-3 years): ▪ Focus on bowel and bladder control. ▪ Conflicts can result in anal-retentive or anal- expulsive personalities. o Phallic Stage (3-6 years): ▪ Pleasure zone is the genitals. ▪ Oedipus and Electra complexes emerge. o Latency Stage (6-puberty): ▪ Sexual impulses are repressed. ▪ Focus on social and intellectual skills. o Genital Stage (puberty onwards): ▪ Sexual interests mature. ▪ Establishment of intimate relationships.  1. Theoretical Models of Personality Development Psychosexual Stages of Development: Defense Mechanisms: Repression: Unconscious blocking of unacceptable thoughts. Denial: Refusal to accept reality. Projection: Attributing one's own unacceptable feelings to others. Displacement: Redirecting emotions to a  1. Theoretical Models of Personality Development Implications for Psychiatric Nursing: o Understanding patients' unconscious motivations. o Recognizing defense mechanisms in patient behavior. o Addressing unresolved conflicts from early developmental stages. o Applying psychoanalytic concepts in therapeutic communication 1. Theoretical Models of Personality Development 1. Theoretical Models of Personality Development b. Erik Erikson’s 4. Industry vs. Inferiority (6-12 Psychosocial years): Coping with new social and academic Theory: demands. Eight Stages of 5. Identity vs. Role Confusion (12-18 years): Psychosocial Developing a sense of self and personal identity. 6. Intimacy vs. Isolation (young adulthood): Development: Forming intimate, loving relationships 7. Generativity vs. Stagnation (middle Trust vs. adulthood): Mistrust (0-1 Creating or nurturing things that will outlast oneself. year): 8. Integrity vs. Despair (late adulthood): Reflecting on life with a sense of fulfillment. Developing trust when caregivers 1. Theoretical Models of Personality Development b. Erik Erikson’s Psychosocial Theory: Concept of Developmental Crises: Each stage presents a crisis that must be resolved. Application in Mental Health Nursing: Successful resolution leads to virtues and Assessing patients' developmental psychological strengths. stages. Supporting patients through life transitions. Facilitating resolution of past developmental 1. Theoretical Models of Personality Development  1. Theoretical Models of Personality Development c. Jean Piaget’s Cognitive Development Theory: 3. Concrete Operational Stage (7- Stages of Cognitive 11 years): Logical thinking about concrete Development: events. Understanding of conservation Sensorimotor Stage and mathematical transformations. (0-2 years): 4. Formal Operational Stage (12 years and up): Learning through Abstract and moral reasoning. sensory experiences Hypothetical-deductive reasoning. and actions. 1. Theoretical Models of Personality Development Jean Piaget’s Cognitive Development Theory: Role of Cognitive Processes in Personality Development: Cognitive structures (schemas) guide understanding. Implications for Psychiatric Care: Assimilation Recognizing and accommodation cognitive as to age. abilities related mechanisms Identifying of cognitive cognitive change. distortions in mental health Adjusting communication strategies accordingly. disorders The need for self actualization and positive regard creat a potential for conflict 1. Theoretical Models of Personality Development  d. Carl Rogers' Humanistic Theory: Concepts: 1. Theoretical Self-Actualization: The Models of innate drive to fulfill one's Personality potential. Development Self-Concept: The organized, consistent set of perceptions of oneself. Unconditional Positive Regard: Acceptance and support regardless of what 1. Theoretical Models of Personality Development 1. Theoretical Models of Personality Development  1. Theoretical Models of Personality Development f. Other Relevant Theories: Karen Horney's Neo-Freudian Approach: o Emphasized social and cultural factors in personality. o Basic Anxiety: Feeling of being isolated and helpless. o Neurotic Needs: Coping strategies that become compulsive. John Bowlby's Attachment Theory: o Importance of early emotional bonds. o Attachment Styles: Secure, anxious, avoidant. o Influence on later relationships and mental health.  2. Concepts of Psychophysiology: a. Neurobiological Foundations: Brain Anatomy Relevant to Psychiatric Conditions: o Prefrontal Cortex: ▪ Executive functions: decision-making, planning, social behavior. ▪ Dysfunctions linked to schizophrenia, ADHD. o Limbic System: ▪ Amygdala: Emotion processing, fear responses. ▪ Hippocampus: Memory formation. ▪ Alterations associated with mood disorders, PTSD. o Basal Ganglia: ▪ Movement regulation, habit formation. ▪ Implicated in OCD and movement disorders. 2. Concepts of Psychophysiology Neurotransmitters and Their Roles: 2. Concepts of Psychophysiology Role of Neuroplasticity: o Brain's ability to reorganize itself. o Impact of learning, experience, and therapy on brain structure and function. o Importance in recovery from mental health disorders.  b. Psychophysiology of Stress and Mental Health: Stress Response Systems: Hypothalamic-Pituitary-Adrenal (HPA) Axis: Activation leads to cortisol release. Chronic activation can impair immune function and increase risk for depression. Autonomic Nervous System: Sympathetic Nervous System: 'Fight or flight' response. Parasympathetic Nervous System: 'Rest and digest' state. Imbalances contribute to anxiety and stress-related disorders.  b. Psychophysiology of Stress and Mental Health: Impact of Chronic Stress: Physiological changes: hypertension, cardiovascular disease. Psychological effects: anxiety, depression, cognitive impairments. Role in development of PTSD. Implications for Nursing: Assessing stress levels and physiological indicators. Implementing stress management techniques. Educating patients about the effects of stress.  c. Biopsychosocial Model of Mental Health: Integration of Factors: Biological: Genetics, neurochemistry, brain abnormalities. Psychological: Personality, emotions, coping skills. Social: Family, culture, socioeconomic status. Application in Practice: Holistic assessment of patients. Multidimensional treatment approaches. Collaborative care involving interdisciplinary teams. d. Genetics and Epigenetics in Mental Health: Genetic Predispositions: Heritability of disorders like bipolar disorder, schizophrenia. Family history as a risk factor. Epigenetic Factors: Gene-environment interactions. How stress, trauma, and lifestyle can alter gene expression. Potential for reversibility with interventions.  e. Mind-Body Connection: Psychophysiological Feedback Loops: Influence of mental states on physical health (e.g., stress-induced ulcers). Physical conditions affecting mental health (e.g., chronic pain leading to depression). Interventions: Biofeedback: Training patients to control physiological functions. Mindfulness Meditation: Reducing stress and improving emotional regulation. Relaxation Techniques: Deep breathing, progressive muscle relaxation References: 1. Boyd, M. A. (2018). Psychiatric Nursing: Contemporary Practice (6th ed.). Wolters Kluwer Health. 2. Videbeck, S. L. (2020). Psychiatric-Mental Health Nursing (8th ed.). Lippincott Williams & Wilkins. 3. Stuart, G. W. (2016). Principles and Practice of Psychiatric Nursing (10th ed.). Elsevier Health Sciences. 4. Sadock, B. J., Sadock, V. A., & Ruiz, P. (2017). Kaplan & Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry (11th ed.). Wolters Kluwer. 5. American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (DSM-5- TR). American Psychiatric Publishing. 6. Varcarolis, E. M. (2020). Essentials of Psychiatric Mental Health Nursing (4th ed.). Elsevier. 7. Urry, H. L., & Gross, J. J. (2017). "Emotion Regulation in Psychopathology." Annual Review of Clinical Psychology, 13, 263-294. 8. McEwen, B. S. (2017). "Neurobiological and Systemic Effects of Chronic Stress." Chronic Stress, 1, 1-11. 9. Siegel, D. J. (2015). The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are (2nd ed.). The Guilford Press. 10. Perry, B. D., & Pollard, R. (2018). "Homeostasis, Stress, Trauma, and Adaptation." Child and Adolescent Psychiatric Clinics, 7(1), 33-51.