Spec. Pops Test 1 .docx

Special Pops (Psych) Test 1 Terms **[MENTAL STATUS EXAMINATION]** Speech ====== - Loosens of Associations: sequence of unrelated to remotely related ideas **"I came here by bus, bussing is kissing, I wasn't kissing but if you keep it simple that is a business tenet for KISS. That wa...

Special Pops (Psych) Test 1 Terms **[MENTAL STATUS EXAMINATION]** Speech ====== - Loosens of Associations: sequence of unrelated to remotely related ideas **"I came here by bus, bussing is kissing, I wasn't kissing but if you keep it simple that is a business tenet for KISS. That was a great group that played on and on but I'm not playing with you. Your are ewe or youthful, too."** - Flight of Ideas: fast speech with frequent shifting of ideas **"How are you doing kid, no kidding around. Im going home... home, sweet, home... home is where the heart is... the heart of this matter is I want out that ain't hay... hey Doc... get me out of this place."** - Tangential: train of thought wanders, lack of focus, never returning to initial thought **"I really got mad as I was waiting in line at the grocery store. I cannot stand lines. Waiting and waiting. I waited for a long time to get my drivers license."** - Circumstantial: conversation drifts then comes back to the point **When asked about the age of a person's mothers death, the patient responds by talking at length about accidents and how too many people die in accidents, then eventually says what the mothers age was at death.** - Thought Blocking: speech interrupted by silence that lasts a few seconds to long - Incoherent: lacks sense - Word Salad: attempted communication but works appear random and unrelated in incoherent sequence. Unaware that did not make sense. **"Whipple sitting purple which the twilighted Cheshire for then frames of silver ticking bubble and."** - Clanging: association of works based upon sound rather than concepts. Compulsive rhyming with logical connection between words. - Neologisms: newly created word whose meaning is unknown to others, made up word. - Echolalia: non-focused speech, no relevance to the situational context, like resting portions of a TV show while walking around a classroom. Repetition or echoing of works or sounds that you hear someone else say. **Affect** - Full Range: wide range of emotional expression, reactive and changing flexibly and appropriately with the flow of conversation. - Appropriate/Congruent: emotions are appropriate for the situation. - Flat: absence of expression - Labile: mood swings, inappropriate laughing/crying due to nervous system disorder - Blunted: severe reduction in intensity of feelings, difficulty expressing their emotions, diminished facial expressions. - Inappropriate Mood: reactions that do not match the situation - Bizarre: easily remembers information that is strange and unusual, remembers randoms facts/figures. - Depressed: persistent feeling of sadness and loss of interest - Euphoric: intense feeling of well-being and happiness, being overly happy, laughing, energetic. **Perception** - Hallucinations: AUDITORY, VISUAL, OLFACTORY (smell) , TACTILE (touch) , GUSTATORY False or distorted sensory perception in the absence of external stimuli. Illusions: misinterpretation of environment Seeing a tiger in the woods when in reality it was a tree branch and shadow --------------------------------------------------------------------------- - Delusions: Rigid and incorrect belief about reality not shared by others; false belief about eternal reality. Patient holds firm to the belief regardless of evidence to the contrary. **Thoughts** - Thought Process (LINEAR): coherent and organized ; if disorganized (LOA and FOI) - Thought Content (DELUSIONS) - Paranoid/Persecutory Delusions: person believes being followed, spied on, harassed, attacked, or drugged/poisoned - Referential Delusions: person believes that gestures, comments, book passages, refer to them (Books/TV) - Bizarre Delusions: farfetched **Organs replaced with someone else's, although no surgical scars ; states they are pregnant (delusion) ; feels baby (hallucination)** - Grandiose: unrealistic sense of superiority (supernatural figure, celebrity), may believe they have special abilities, power, or possessions - Somatic: psychological concerns convert to physical symptoms, false belief that a person's internal or external bodily functions are abnormal **Infected with parasites** - Ideas of Reference: misinterpretation of incidents and events in outside/external world **Walking into a crown that is laughing and believing the laughing is about them** - Thought Withdrawal: believes an outride force took their thoughts away - Thought Insertion: believes an outside force (CIA, FBI, Aliens) have the power to put thoughts into one's mind - Thought Broadcasting: belief that others hear their thoughts Sensorium/Cognition: highest grade completed, capital of France, last 5 presidents Proverb: What does "people in glass house shouldn't throw stones" mean to you? **This determines concrete (literal) abstract thinking** Analogy: What does a car, plane, and a train have in common? Memory: Immediate (3-5 min), Recent (within 24 hours), Remote (1 year) Attention Span: 3 stage command (get paper, put parer on desk, put paper on floor, fold the paper), spell "world" forwards then backwards, serial 7s or 3s from 100. Insight: Judgement: You are in a movie theatre and you see smoke, what do you do? Reliability: **[COMMUNICATION]** **Defense Mechanisms** Rationalization: making excuses, justifying behavior with logical reasons avoiding the true reason "Sorry I'm late, I caught the train." ------------------------------------- Regression: returning to an earlier (ex: childhood) way of dealing with stress rather than resolving conflict Slamming doors, giving the cold shoulder ---------------------------------------- Denial: refusal to accept reality of situation or experiencing the situation (ex: dealing with bad habit, refuse the truth) **"No, I'm a social drinker, not a drunk"** Compensation: overachievement in one area to offset real or perceived deficiencies Student with low self esteem becomes the teachers helper, so teacher will like her ----------------------------------------------------------------------------------------------------------------------------------------------------------------------- Displacement: ventilating intense feelings to a less intensive person; transferring frustration to another Husband gets a bad employment review then comes home and gets in a fight or gets abusive with spouse or children or gets in a road rage situation (legal issues) ---------------------------------------------------------------------------------------------------------------------------------------------------------------- Projection: an individual attributes unwanted thoughts, feelings, and motives onto another person Blaming partner of cheating when you have an unconscious desire to cheat ------------------------------------------------------------------------ - Reaction Formation: acting opposite from how the person is feeling or thinking **Person who dislikes children becomes a super mom** - Conversion: expression of emotional conflict through development of a physical complaint Student who becomes blind on the day of the final ------------------------------------------------- - Sublimination: satisfying impulse (aggression) in a socially acceptable way **After a stressful day a person exercises longer than usual** - Altruism: An act of goodwill towards another person **Helpful to a person who we feel might dislike us or neutralizing an argument with kind words and positivity** - Avoidance: Escapes/neglects to deal with the anxiety **Calling in sick on the day of your presentation or leaving the issue unresolved rather than confronting it** - Humor: a "mature" defense mechanism. Looking for a funny aspect in an environment in which we lack control and can even be an altruistic act in helping others to better cope as well **Making a joke out of embarrassment** **Transference & Countertransference** - Transference: a way patients "transfer" feelings from important persons in their early lives onto another (nurse/HCP) - Projection VS Transference: -Projection: attributing one's own characteristics or feelings to another person **Having an affair, but blaming spouse for having an affair** -Transference: when one's past feelings toward someone else are felt toward a different person in the present. Past feelings expressed on an innocent person **Patient is mad at the MD, but take it out on the nurse** - Countertransference: HCP transfers emotions/feelings onto the patient **HCP or nurse takes out anger on the patient** **Types of Groups** - Psychotherapy Groups: individuals learn about their behavior to make a positive change in behavior **Dealing with stress and improving relationships with others** - Educational Goal Focused: conveying knowledge and information **Support groups (discharge planning and aftercare (NAMI, Outpatient)** - Self Help Groups: all share common issues (AA, AI, Anon, gender/age specific groups) **Therapeutic Factors of Groups** - Instillation of Hope: recovery is possible - Universality: feelings/issues shared by all **"You are not alone" - Group Cohesion** - Altruism: supporting the well being of others - Catharsis: relief of emotional tension - Existential Factors: life and death are real - Corrective Recapitulation of Family of Origin Issues: identifying and changing dysfunctional patterns or roles one played in the family **Phases of Group Development** - Initial/Orientation Phase: initially members are superficial (polite, want to be accepted) -Look to leader for guidance -Define topic for group -Establish rules and goals -Address and promotes trust - Storming (Working Phase): Productive work toward task completion -Leader role: diminishes; facilitates and guides -Members role: provide and receive feedback -listen to others provided feedback -working through conflicts -advantages: realizes other have the same issues -drawbacks: resist change, fear future group breakup - Adjourning (Termination Phase): termination of the group, review of group work, accomplishments reviewed and discussed -drawback: sense of loss/abandonment **Leadership Styles** - Authoritarian/Autocratic: leaders tell groups members what they want done and how to accomplish it without getting advice - Participative/Democratic: group members are included in making decisions and determining what to do and how to do it - Laissez-Faire (Free Reign): leader allows the group to make decisions, this is utilized when group members are productive, the style is to be used when group members are trusted and confident in the task at hand. \***Good leaders use all 3 with 1 being dominant** COGNITION SCHIZOPHRENIA ======================= - Schizophrenia: a thought disorder, a cognitive disorder in which one's thoughts, feelings, and behaviors are altered. They often experience delusions (false, fixed beliefs) and hallucinations, and disorganized thinking - Positive Symptoms: TYPE 1 - Blantant (unashamed) , psychotic symptoms -Hallucinations, delusions, confused disorganized speech, trouble concentrating, movement disorders - Negative Symptoms: TYPE 2 - More subtle expressions of illness - Alogia: naturally quiet, don't say much, "poverty of speech" - Affective Blunting: difficulty expressing their emotions, diminished facial expressions Anhedonia: diminished ability to experience pleasant emotions, finds no joy in anything - Attentional Impairments: - Avolition: poor motivation - Asocial: lack of motivation to engage in social interactions - Anergia: lack of energy **Types of Schizophrenia** - Disorganized: disorganized behavior and speech and included a disturbance in emotional expression - Paranoid: paranoid delusions occur - Undifferentiated: two or more types of schizophrenia in one patient - Residual: past history of at least one episode of schizophrenia bur the person is currently not having any positive symptoms - Catatonic: staying completely still and mute, or may be hyperactive for no reason **Other Psychotic Disorders** - Schizophreniform: schizophrenia that last only one-six months instead of a life time - Schizoaffective: a combination of schizophrenia and mood disorder such as depression or bipolar - Delusional: delusions occur - Brief Psychotic Disorder: sudden, short term display of psychotic behavior, such as hallucinations or delusions, which occur in a stressful event - Psychotic Disorder NOS: when there is an inadequate amount of information to make a specific diagnosis - Substance Induced Psychotic Disorder: hallucinations or delusions due to direct effect of a substance or withdrawal from a substance in the absence of delirium