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Mental Health
Chapter 14: Psychotic Disorders
| Term | Definition |
|---|---|
| What do schizophrenia spectrum and other psychotic disorders affect? (pg. 118) | Thinking, behavior, emotions & the ability to perceive reality |
| What causes schizophrenia? | Combination of genetic, neurobiological, and non genetic (injury at birth, viral infection and nutritional) factors |
| Typical age onset of schizophrenia? -What about age 7 | Late teens and early 20s. Can occur in young children and late adulthood --> dx not for younger than 7 bc it could be ADHD |
| Schizophrenia: define | Psychotic thinking or behavior present for a least 6 months. Function areas: school/work/self-care/relationships are impaired |
| Schizotypal personality disorder: define | Impairments of personality (self and interpersonal) functioning. --> Impairment is not as severe as w/ schizophrenia |
| Delusional disorder: define | Delusional thinking for at least 1 month. Self or interpersonal functioning is not markedly impaired |
| Brief psychotic disorder: define | Psychotic s/s lasting between 1 day to 1 month |
| Schizophreniform disorder: define | S/S similar to schizophrenia but the duration is 1-6 months, and social/occupational dysfunction may/may not be present |
| Schizoaffective disorder: define | Client's disorder meets both the criteria for schizophrenia and depressive or bipolar disorder |
| Substance-induced psychotic disorder: define | Psychosis within 1 month of substance intoxication or withdrawal. May be caused by meds intended for therapeutic use. |
| Characteristics of psychotic disorders: 1. Positive symptoms define & examples | Manifestations of things that are not normally present -Hallucinations, delusions, alterations in speech, bizarre behavior like walking backwards |
| 2. Negative symptoms define | The absence of things that are normally present (more difficult to treat) |
| Negative symptoms examples -Affect: define | Usually blunted (narrow range of normal expression) or flat (facial expression never changes) |
| Negative symptoms examples -Alogia: define | Poverty of thought or speech; client may sit w a visitor but mumbles or vaguely responds |
| Negative symptoms examples -Anergia: define | Lack of energy |
| Negative symptoms examples -Anhedonia: define | Lack of pleasure or joy; the client is indifferent to things that often make others happy |
| Negative symptoms examples -Avolition: define | Lack of motivation in activities & hygiene |
| 3. Cognitive symptoms: define & examples | Problems with thinking make it very difficult for the client to live independently --> disordered thinking, inability to make decisions, poor problem-solving ability, difficulty concentrating to perform tasks |
| Cognitive symptoms examples continued -Memory deficits; expand | Long-term memory & working memory (inability to follow directions to find an address) |
| 4. Affective symptoms: define & examples | Manifestations involving emotions --> Suicidal ideation & hopelessness |
| Examples of delusions! (Pg. 119) 1. ideas of reference | misconstrues trivial events & attaches personal significance to them -ex. believing that others, who are discussing the next meal, are talking about him |
| Examples of delusions 2. Persecution | Feels singled out for harm by others (ie. being hunted down by the FBI) |
| Examples of delusions 3. Grandeur | Believes that she is all powerful & important, like god |
| Examples of delusions 4. Somatic delusions | Believes that his body is changing in unusual ways, such as growing a 3rd arm |
| Examples of delusions 5. Jealousy | May feel that her spouse is sexually involved with someone else |
| Examples of delusions 6. Being controlled | Believes that a force outside his body is controlling him |
| Examples of delusions 7. Thought broadcasting | Believes that her thoughts are heard by others |
| Examples of delusions 8. Thought insertion | Believes that others thoughts are being inserted into his mind |
| Examples of delusions 9. Thought withdrawal | Believes that thoughts have been removed from her mind by an outside agency |
| Examples of delusions 10. Religiosity | Being obsessed with religious beliefs |
| What are delusions? Define | Alterations in thought; false fixed beliefs that can't be corrected by reasoning and are usually bizarre |
| Alterations in speech (positive) examples 1. Flight of ideas | Associative looseness, client may say sentence after sentence, but each sentence may relate to another topic, and the listener is unable to follow the client's thoughts |
| Alterations in speech (positive) examples 2. Neologisms | Made-up words that have meaning only to the client |
| Alterations in speech (positive) examples 3. Echolalia | The client repeats words spoken to him |
| Alterations in speech (positive) examples 4. Clang association | Meaningless rhyming of words, often forceful, such as "oh fox, box and lox" |
| Alterations in speech (positive) examples 5. Word salad | Words jumbled together w little meaning or significance to the listener; such as "hip hooray, the flip is cast and wide-sprinting forest" |
| What are hallucinations? | Alterations in perceptions; sensory perceptions that do not have any apparent external stimulus. |
| Hallucination examples 1. Auditory | Hearing voices or sounds -command; voice instructs to do something |
| Hallucination examples 2. Visual | Seeing persons or things |
| Hallucination examples 3. Olfactory | Smelling odors |
| Hallucination examples 4. Gustatory | Experiencing tastes |
| Hallucination examples 5. Tactile | Feeling bodily sensations |
| Different alterations in perception: 3 types | Hallucinations, Personal boundary difficulties, Alterations in behaviors |
| Personal boundary difficulties are? | Disenfranchisement with one's own body, identity, and perceptions. |
| Types of personal boundary difficulties are? | Depersonalization and derealization |
| Depersonalization is? | Nonspecific feeling that a person has lost her identity; self is different or unreal |
| Derealization is? | Perception that the env't has changed |
| Alterations in behavior examples 1. Extreme agitation | Including pacing & rocking |
| Alterations in behavior examples 2. Stereotyped behaviors | Motor patterns that had meaning to client (sweeping the floor) but now are mechanical and lack purpose |
| Alterations in behavior examples 3. Automatic obedience | Responding in a robotlike manner |
| Alterations in behavior examples 4. Wavy flexibility | Excessive maintenance of position |
| Alterations in behavior examples 5. Stupor | motionless for long periods of time, comalike |
| Alterations in behavior examples 6. Negativism | Doing the opposite of what is requested |
| Alterations in behavior examples 7. Echopraxia | Purposeful imitation of movements made by others |
| Standardized screening tools 1. GAF | Global assessment of functioning scale -helps to determine ADLs and function independently -appropriate for all clients who have a mental health disorder |
| Standardized screening tools; other | Scale for assessment of negative symptoms, brief psychiatric rating scale (BPRS), and abnormal involuntary movements scale (AIMS) |
| What is milieu care? nursing | A structured, safe environment for the client in order to decrease anxiety and to distract the client from constant thinking about hallucinations |
| What is ACT? | Assertive community tx: intensive case management and inter professional team approach to assist clients w community living needs |
| Appropriate communication w clients when addressing hallucinations? | -ask directly -cannot argue or agree with anything the client is saying but can say "i do not hear anything but you seem frightened" -focus on feelings when addressing the hallucinations, don't argue -Focus on reality based (attempt) |
| Atypical antipsychotics: tx.. | generally both positive and negative symptoms |
| Example of atypical antipsychotics | Risperidone (risperdal), Olanzapine (zyprexa), Quetiapine (Seroquel), Ziprasidone (geodon), Aripiprazole (abilify), Clozapine (clozaril) |
| S/E for the atypical medications? | Wt gain: advise client to follow a healthy, low-calorie diet, engage in regular exercise & monitor wt -s/s agitation, dizziness, sedation & sleep disruption may occur |
| Conventional antipsychotics.. used for | Positive symptoms mainly |
| Conventional antipsychotic examples | Haloperidol (Haldol), loxapine (loxitane), chlorpromazine (thorazine), fluphenazine (prolixin) |
| Conventional antipsychotic s/e: | Anticholinergic effects; to avoid these--> chew sugarless gum, eat ^ fiber foods & drink 2-3L fluids/day |
| Conventional antipsychotic s/e: blood pressure | Postural hypotension: sit or lie down. get up slowly |
| Antidepressants: | Paroxetine (Paxil) |
| Paxil; used for how long? and may increase risk for what when first using? | Temporarily. self-harm, Don't abruptly stop (withdrawal) |
| Anxiolytics/benzodiazipines; | Lorazepam (Ativan), Clonazepam (Klonopin) |
| Anxiolytics/benzodiazipines s/e: | Sedative effects, blood tests to monitor agranulocytosis, caution in elderly |
Created by:
mary.scott260!
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