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Assess/Diagnoses
Midterm Exam-DSM, Axis, MMSE, GAF, Dementia, Schizophrenia, ego functions, etc
| Question | Answer |
|---|---|
| Purpose of the DSM | Reference manual that utilizes a multi-axial assessment process which incorporates all the systems in a client's life; helps determine treatment options, plans, recourses available |
| Labeling | mental illness label can be for "life," can impact client's will to get out of situation, can cause negative sense of acceptance; leads to stigma |
| Stigma | labeling, stereotyping, creates divisions, discriminating; lack of knowledge can lead to fear; double stigmas exist for people with multiple diagnoses or other stereotypes coupled with mental illnesses. |
| Social Constructionism | created by society to be viewed as natural but is the opposite; based on specific cultures. |
| Psychosocial Assessment | Biological (family history, development, physical), Psychological (mental status, cognitive processes, coping), Social (support, culture, community, spiritual, religion, etc.); Previous treatment, current meds, eating/sleeping habits, suicide ideation |
| Purpose of assessment | identify needs and intervention strategies; never ends (unless ER social worker, etc). |
| MMSE (Mini-Mental Status Exam) | Assesses cognitive functioning; the closer to 30 its, the higher the functioning; 0-17 severe impairment, 18-23 mild, 24-30 No impairment; based on education level, and gives odds for dementia |
| Axis I | Mental disorder |
| Axis II | personality disorder and mental retardation |
| Axis III | general medical conditions |
| Axis IV | psychosocial and environmental problems; assess access to healthcare, education issues, anxiety, interaction with legal system, economic problems, etc. |
| Axis V | GAF-Global Assessment of Functioning; current is most relevant; social workers tent to overrate functionality of clients |
| Norepinephrine | neurotransmitter that regulates anxiety and tension |
| Dopamine | neurotransmitter that regulates motor activity and effects cognition |
| Serotonin | neurotransmitter that effects nervous system and moods (depression, etc.) |
| Histamine | neurotransmitter that effects body's allergic reactions; high levels can cause panic attacks, etc. |
| Acetylcholine | neurotransmitter that regulations function of central nervous system and peripheral nervous system |
| Gamma-amino butyric acid | neurotransmitter that regulates neuron excitability in the nervous system |
| Chemical malfunctions that cause mental illness | quality of neurotransmitters, alignment, quantity, distance from one another |
| Antipsychotics | Antagonists; block receptors in the brain (dopamine) to help reduce delusions, hallucinations, etc. |
| Antidepressants | impacts on production of serotonin |
| Mood stabilizers | commonly prescribed for people with mood disorders. e.g.: bipolar disorder |
| Anti Anxiety | helps control anxiety |
| Psycho-stimulants | used to treat ADHD, sleep disorders, and obesity |
| Denial | Ego defense; level 1; arguing against an anxiety provoking stimuli by stating it doesn't exist |
| Displacement | Ego defense; level 2; taking out impulses on a less threatening target |
| Intellectualization | Ego defense; level 3; avoiding unacceptable emotions by focusing on the intellectual aspects (focusing on the details of a funeral instead of sadness and grief) |
| Projection | Ego defense; level 2; placing unacceptable impulses in yourself onto someone else |
| Rationalization | Ego defense; level 3; supplying a logical or rational research reason as opposed to the real reason |
| Reaction formation | Ego defense; level 3; siding with the aggressor; taking the opposite belief because the true belief causes anxiety |
| Regression | Ego defense; level 1; returning to a previous stage of development |
| Repression | Ego defense; level 3; Pulling into the unconscious |
| Sublimation | Ego defense; level 3; acting out unacceptable impulses in a socially acceptable way |
| Suppression | Ego defense; level 3; pushing into the subconscious |
| Level 1 ego defenses | low functioning; psychotic; extremely pathological |
| Level 2 ego defenses | Immature |
| Level 3 ego defenses | Healthier (higher functioning) |
| GAF | Global Assessment Functioning scale; considers psychological, occupational, and social functioning; the lower the score, the lower the functioning; useful in planning treatment, measuring impact, and predicting outcome. |
| Social Work best practices in medication management | good working relationship with M.D.; understand severity of symptoms, have family support, educate, prepare client, follow up on referrals, be cognizant of legal and ethical issues; understand client has right to self determination |
| Signs | any indication of a medical conditions that can be objectively observed; crying, tremors, chest pain |
| Symptom | subjective; manifestation of a symptom that is apparent to the patient; anxiety, loss of appetite, sadness |
| Signs and symptoms of Dementia, Alzheimer's Type | Development of multiple cognitive deficits including memory impairment and at least one cognitive disturbance (aphasia, apraxia, agnosia, disturbance in executive functioning); diagnoses when all other central nervous systems are ruled out. |
| Aphasia | language disturbance |
| Apraxia | impaired ability to carry out motor activities despite intact motor function |
| Agnosia | failure to recognize or identify objects despite intact sensory function |
| Disturbance in executive functioning | disturbance in planning, organizing, sequences, abstracting |
| Diagnostic criteria for Dementia, Alzheimers Type | Memory impairment, cognitive disturbances, impairment to social and occupational functioning, gradual onset/continuing cognitive decline, no central nervous system/systemic/substance induced conditions; not delirium induced, no other Axis 1 disorder noted |
| Causes of Dementia, Vascular Type | Vascular disease; risk factors are cardiovascular and cerebrovascular disease |
| Focal Neurological Signs and Symptoms of Dementia, Vascular Type | Extensor plantar response, pseudobulbar palsy, gait abnormalities, exaggeration of deep tendon reflexes, or weakness of extremity; CT/MRI show vascular lesions of cerebral cortex and subcortical structures |
| Signs and Symptoms for Schizophrenia, Paranoid Type | preoccupation with one or more delusions or frequent auditory hallucinations; no other active phase symptoms present |
| Schizophrenia | Psychotic disorder that lasts at least 6 months and includes at least 1 month of active-phase symptoms (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms) |
| Diagnostic criteria for Schizophrenia (basic) | 2+characteristic symptoms present for 1m period, social/occupational disfunction; disturbances for 6+m,exclusion of Schizoaffective/Mood Disorders (no major manic episodes, brief mood alters), no substance induction, pervasive develop. disorder ruled out. |
| Characteristic symptoms of Schizophrenia | Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms (affective flattening, alogia (poverty of speech), or abolition (lack of motivation/drive) |
| Signs and symptoms for Schizophrenia, Catatonic Type | presence of two psychomotor disturbances: motoric immobility, extreme negativism (resistance to all instruction), excessive motor activity (purposeless), peculiar voluntary movements, echolalia(repeating sounds/words) or echopraxia(repeating movements) |
| Signs and symptoms for Schizophrenia, disorganize type | Following are present: disorganized speech, disorganized behavior, flat or inappropriate affect; no criteria for catatonic type |
| Positive Symptoms of Schizophrenia | hostility, excitement, delusions, suspiciousness/persecution, hallucinatory behavior, conceptual disorganization, grandiosity |
| Negative Symptoms of Schizophrenia | emotional withdrawal, passive apathetic withdrawal, difficulty in abstract thinking, blunted affect, lack of spontaneity/flow of conversation, stereotyping thinking, poor rapport |
| Delusions | false personal beliefs that are not a part of the person's culture; person truly believes something that doesn't make sense to others around them, reasoning doesn't work |
| Hallucinations | sensing things that aren't there (hearing, seeing, smelling, tasting, touching things that others do not perceive) most common=hearing voices |
| Disorganized thinking | being unable to think straight, therefore unclear communication; unable to concentrate on one thing for long; thoughts blocked or fragmented |
| Agitation/Excitement | appearing very excited, restless or hyperactive |
| Grandiosity | believing they are powerful, very wealthy or have special powers |
| Suspiciousness | being mistrusting or guarded; might believe they are being watched or followed |
| Hostility | behaving in an abusive, sarcastic and uncooperative manner |
| Lack of Drive | lack of energy to start or do anything, even simple tasks |
| Social Withdrawal | absorbed in own thoughts and senses, spend most of time alone |
| Emotional unresponsiveness | absence of feeling |
| Lack of spontaneity | hesitancy in speech or action; unnatural or slow movement |
| Difficulty in Abstract Thinking | concrete thinking only; can't see underlying meaning of things; can't move from specific to the general |
| Poor communication skills | avoid eye contact and conversation |
| Stereotyped thinking | rigid attitudes and beliefs that may seem unreasonable to others; repetitive and intrusive thoughts |
| Physical symptoms for psychotic disorders | physical activity may slow down or stop |
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