214 terms psychiatric questions How are the concepts of mental defined? They are culturally defined.

What are the 2 types of responses people experience from stress? Physical and psychological.

What needs to be considered when deciding if an individual is adapting successfully to stressors? The person's age, local and cultural norms.

What is "incomprehensibility"? The inability of the general population to understand the motivation behind a behavior.

What is "cultural relativity"? The "normality" of behavior as determined by the culture.

Who coined the definition of incomprehensibility and cultural relativity? Horwitz

What is "general adapatation syndrome (GAS)"? Another term for the flight or fight in response to stress.

 Who coined the term GAS? Hans Selye.

What are the 3 stages of GAS? The alarm reaction stage, stage of resistance, and stage of exhaustion.

Define the Alarm reaction stage of GAS? When stress triggers the flight or fight response.

Define the Stage of resistance of GAS? When an individual uses the physiological responses from the alarm reaction stage as a defense in order to adapt to a stressor.

Define the Stage of exhaustion? When exposure to a stressor is prolonged to the point that the body can no longer adapt to the stressor.

What is the body's immediate response during the alarm reaction stage? The hypothalamus stimulates the sympathetic nervous system which results in the release of epi and norepi. Pupils dilate, resp rate increases, bronchioles dilate, pulse increases, BP increase, force of cardiac contraction and cardiac output increases tear gland secretion increases, GI motility decreases and sphincters contract.

Describe how the body handles the sustained response to stress The hypothalamus stimulates the pituitary to release hormones.

What hormones are released during the sustained response to stress Adrenocorticotropic hormone (ACTH), Vasopressin (ADH), Growth hormone, Thyrotropic hormone, and Gonadotropins.

Describe the effects of each hormone during the sustained response to stress ACTH to stimulate the adrenal cortex to release glucocorticoids and mineralcorticoids resulting in increased gluconeogenesis and retention of Na and water. ACTH also decreases immune and inflammatory response. ADH increases BP through vasoconstriction and increases fluid retention. Thyrotropic hormone stimulates the thyroid gland to increase BMR. Growth hormone increases metabolism of protein, carbs, and lipids, it also increases serum glucose and free fatty acids. Gonadotropins cause a decrease in secretion of sex hormones resulting in decreasing libido and impotence.

What are the psychological responses to the chronic response to stress Anxiety and grief.

Define anxiety A diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness.

What are Peplau's 4 levels of anxiety Mild, Moderate, Severe, and Panic.

Describe Peplau's mild level of anxiety in detail Tension of day to day living. Senses are sharp, motivation is increased, and awareness of environment is heightened. Learning is enhanced.

Describe Peplau's moderate level of anxiety in detail Perceptual field diminishes. Less alert to stimuli. Attention span and concentration decreases. Muscular tension and restlessness may be evident.

Describe Peplau's severe level of anxiety in detail Perceptual field is very diminished to the point that concentration centers on one detail or on many extraneous details. Limited attention span. All behavior is is aimed at relieving the anxiety.

Describe Peplau's panic level of anxiety in detail Individual is unable to focus on anything. Loss of contact with reality may be evident. Behavior may be wild and desperate or have extreme withdrawal. Prolonged panic anxiety can lead to physical and emotional exhaustion and can be life threatening.

What are the behavioral adaptations shown in the mild level of anxiety Various coping mechanisms are used to deal with stress. Examples include eating, drinking, sleeping, exercise, or just having conversation with someone.

What are the behavioral adaptations shown in the mild to moderate level of anxiety The ego calls on all of the defense mechanisms. They are: Compensation, denial, displacement, identification, intellectualization, introjection, isolation, projection, rationalization, reaction formation, regression, repression, sublimation, suppression, undoing.

 Define Compensation Covering up a real or perceived weakness by emphasizing a trait one considers more desirable.

Define Denial Refusal to acknowledge the existence of a real situation or feelings associated with it.

Define Displacement Feelings are transferred from one target to another.

Define Identification To try and increase self-worth by acquiring attributes of an a person one admires.

Define Intellectualization To avoid expressing emotions associated with a stressful situation by using logic, reasoning, and analysis.

Define Introjection Integrating the beliefs and values of another person into one's own ego structure.

Define Projection Feelings or impulses unacceptable to one's self are taken out on another person.

 Define Rationalization Making excuses or formulate logical reasons to justify unacceptable feelings or behaviors.

Define Reaction Formation Preventing unacceptable thoughts or behaviors from being expressed by exaggerating opposite thoughts or behaviors.

Define Regression To retreat to an earlier level of development to cope with stress.

Define Repression Involuntary blocking of unpleasant feelings from one's awareness.

Define Sublimation Rechanneling of drives or impulses that are personally or socially unacceptable into activities that are more tolerable.

Define Suppression Voluntary blocking of unpleasant feelings from one's awareness.

Define Undoing To symbolically negate or cancel out a previous action that one finds intolerable.

 What are Neuroses and what causes them Can be caused by extended periods of repressed severe anxiety. These are psychiatric disturbances characterized by excessive anxiety or depression, disrupted bodily funtions, unsatifying interpersonal relationships, and behaviors that interfere with routine functioning.

What are psychoses and what causes them Extended periods of functioning at a panic level. These are serious psychiatric disturbances characterized by the presence of delusions or hallucinations or both.

What are examples of neuroses Anxiety disorders, somatoform disorders, and dissociative disorders.

What are examples of psychoses Schizophrenia and delusional disorders.

What is the definition of grief A subjective state of emotional, physical, and social responses to the loss of a valued entity. The loss may be real or perceived.

What is Kubler-Ross's contribution to the study of grief He identified 5 stages of the grief process.

What are the 5 stages of grief Denial, anger, bargaining, depression, and acceptance.

Define anticipatory grief Experiencing the grief process before the actual loss.

What can cause a lengthening of the grief process When an individual has experienced a number of recent losses and is unable to complete one grieving process before another one begins.

What can shorten the grief process Anticipatory grieving.

How does one know when resolution of grief has been accomplished When someone can look back on the relationship with the lost entity and accept both the positive and negative aspects of the association.

What is a delayed or inhibited response to loss When one is fixed in the denial stage. The loss is not experienced.

What is a distorted response to loss When one is fixed in the anger stage. All normal behaviors of grieving are exaggerated. The person turns the anger inward on the self and is consumed with overwhelming despair.

 Define Axis I Clinical disorders and other conditions that may be a focus of clinical attention.

Define Axis II Personality disorders and mental retardation.

Define Axis III General medical conditions.

Define Axis IV Psychosocial and environmental problems.

Define Axis V Global assessment of functioning rated on the Global Assessment of Functioning (GAF) Scale.

What does the Global Assessment of Functioning Scale (GAF) measure A person's psychological, social, and occupational functioning.

How does the book define personality

A combination of character, behavioral, temperamental, emotional, and mental traits that are unique to each specific person.

What do Life-Cycle developmentalists believe? That people continue to develop and change throughout life.

How are the stages of life by Life-Cycle developmentalists identified By age.

What do Life-Cycle developmentalists believe about behavior and change? They believe that a person can change over time. Therefore people can be working on tasks from more than one stage at a time.

According to Freud, when is basic character formed By the age of 5.

What are the 3 levels of organization of personality according to Freud Id, Ego, and Superego.

What is the Id Present at birth. It serves to satisfy needs and achieve immediate gratification. AKA the pleasure principle.

What is the Ego Begins at age 4-6 months. Serves as the rational part of the personality. Works to maintain harmony between the outside world, Id, and superego. AKA the reality principle.

What is the Superego Begins at age 3-6 years old. Composed of the ego-ideal and conscience. AKA the perfection principle.

What is the ego-ideal Self-esteem developed in response to positive feedback.

What is the conscious The culturally influenced sense of right and wrong.

What are the differences between the conscious, preconscious, and unconscious A person is aware of memorial in the conscious, in the preconscious memorial may be forgotten but can be recalled back into consciousness, in the unconscious memories are forgotten and unable to be recalled.

What is psychic energy? A term by Freud. It is the force required for mental functioning.

What is Cathexis A term coined by Freud. It is the process by which the id invests energy into an object in an attempt to achieve gratification.

 What is Anticathexis The use of psychic energy by the ego and superego to control id impulses.

What are the 5 stages of development per Freud Oral, Anal, Phallic, Latency, and Genital stages.

Describe the oral stage From birth to 18 months. Relief from anxiety through oral gratification.

Describe the Anal stage 18 months to 3 years. Learning independence and control with focus on excretory functions.

Describe the Phallic stage 3-6 years old. Identification with parent of the same gender, development of sexual identity, focus on genital organs.

Describe the Latency stage 6-12 years old. Sexuality repressed, focus on relationships with same-gender peers.

Describe the Genital stage

13-20 years old. Libido is awakened. Focus on relationships with the opposite gender is increased.

What is the gist of H.S. Sullivan's Interpersonal Theory That individual behavior and personality development are the direct result of interpersonal relationships.

What are major components of the Interpersonal Theory Anxiety, Satisfaction of needs, Interpersonal security, Self-system, The "good me", The "bad me", and The "not me".

Define the anxiety component of the Interpersonal Theory A feeling of emotional discomfort. The relief of this anxiety is the aim of all behavior.

Define the Satisfaction of needs component of the Interpersonal Theory Fulfillment of all requirements associated with an individual's physiochemical environment.

Define the Interpersonal security component of the Interpersonal Theory The feeling associated with relief from anxiety.

Define the "good me" component of the Interpersonal Theory The part of personality that develops in response to "+" feedback.

Define the "bad me" component of the Interpersonal Theory The part of personality that develops in response to "-" feedback.

Define the "not me" component of the Interpersonal Theory The part of personality that develops in response to situations that produce intense anxiety.

What are H.S. Sullivan's 6 stages of development Infancy, Childhood, Juvenile, Preadolescence, Early adolescence, and Late adolescence.

What is the Infancy stage according to Sullivan Birth to 18 months. Relief from anxiety through oral gratification.

What is the Childhood stage according to Sullivan 18 months to 6 years. Learning to experience a delay in personal gratification without undue anxiety.

What is the Juvenile stage according to Sullivan 6 to 9 years old. Learning to form satisfactory peer relationships.

What is the Preadolescence stage according to Sullivan 9 to 12 years. Learning to form satisfactory relationships with persons of the same gender. The initiation of feelings of affection for another person.

 What is the Early adolescence stage according to Sullivan 12 to 14 years. Learning to form satisfactory relationships with people of the opposite gender. Developing a sense of identity.

What is the Late adolescence stage according to Sullivan 14 to 21 years. Establishing self-identity; working to develop a lasting and intimate relationship with the opposite gender.

What is E. Erikson's Theory of Psychosocial Development based on The influence of "social" processes on the development of the personality.

What are E. Erikson's 8 stages of development Infancy, Early childhood, Late childhood, School age, Adolescence, Young adulthood, Adulthood, and Old age.

What is the Infancy stage according to Erikson Birth to 18 months. Trust vs mistrust. To develop a trust in the mothering figure and be able to generalize it to others. If failed, difficulty with interpersonal relationships results.

What is the Early childhood stage according to Erikson 18 months to 3 years. Autonomy vs shame and doubt. To gain some self-control and independence within the environment. Failure results in a lack of self-confidence, lack of pride, a sense of being controlled by others, and rage against self.

What is the Late childhood stage according to Erikson 3 to 6 years. Initiative vs guilt. To develop a sense of purpose and the ability to initiate and direct own activities. Failure results in feelings of inadequacy and guilt.

What is the School age stage according to Erikson 6 to 12 years. Industry vs inferiority. To achieve a sense of self-confidence by learning, competing, performing successfully, and receiving recognition from others. Failure results in difficulty in interpersonal relationships due to feeling inadequate.

What is the Adolescence stage according to Erikson 12 to 20 years. Identity vs role confusion. To integrate the tasks mastered in the previous stages into a secure sense of self. Failure results in a sense of self-consciousness, doubt, and confusion about one's role in life.

What is the Young adulthood stage according to Erikson 20 to 30 years. Intimacy vs isolation. To form a lasting relationship or a commitment to another person. Failure results in withdrawal, social isolation, and the inability to form lasting and intimate relationships.

What is the Adulthood stage according to Erikson 30 to 65 years. Generativity vs stagnation. To achieve the life goals established for oneself while also considering welfare of future generations. Failure results in lack of concern for the welfare of others and total preoccupation with the self.

What is the Old age stage according to Erikson 65 years to death. Ego integrity vs despair. To review one's life and derive meaning from both "+" and "-" events in order to achieve a positive sense of self-worth. Failure results in a sense of self-contempt and disgust with how life has progressed.

 What is M. Mahler's Theory of Object Relations based on The separation-individuation process of the infant from the maternal figure.

What are the 3 phases of the Mahler's Theory of Object Relations Phase I: The Autistic phase, Phase II: The Symbiotic phase, Phase III: Separation-Indivduation.

Describe Mahler's Phase I: Autisistic phase Birth to 1 month. Fulfillment of basic needs for survival and comfort. AKA normal autism.

Describe Mahler's Phase II: Symbiotic phase 1 to 5 months. Developing awareness of external sources of need fulfillment. Lack of nurturing in this phase may lead to symbiotic psychosis.

Describe Mahler's Phase III: Separation-Individuation phase 5 to 36 months. The process of separating from mothering figure and the strengthening of the sense of self. This phase is broken down into 4 subphases.

Describe the 4 subphases of Mahler's Phase III: Separation-Individuation phase Subphase 1: Differentiation(5-10 months). Beginning of a primary recognition of separateness from the mother. Subphase 2: Practicing (10-16 months). Increased independence through locomotor functioning; increased sense of separatness of self. Subphase 3: Rapprochement (16-24 months). Acute awareness of separateness of self; learning to seek "emotional refueling" from mothering figure to maintain feeling of security. Subphase 4: Consolidation (24-36 months). Sense of separateness established; on the way to object constancy: able to internalize a sustained image of loved object or person when it is out of sight; resolution of separation anxiety.

 What is the gist of H.E. Peplau's Nursing Model of Interpersonal Development Peplau applied H.S. Sullivan's Interpersonal Theory to the nurse-client relationship development. He correlates the stages of personality development in childhood to stages through which clients advance during the progression of an illness.

What are the 6 nursing roles according to Peplau Resource person, Counselor, Teacher, Leader, Technical expert, and Surrogate.

What is Stage 1 of Peplau's Personality development theory (Infant stage) Learning to count on others. Learning to communicate in various ways with the primary caregiver in order to have comfort needs fulfilled.

What is Stage 2 of Peplau's Personality development theory (Toddler stage) Learning to delay gratification. Learning the satisfaction of pleasing others by delaying selfgratification in small ways.

What is Stage 3 of Peplau's Personality development theory (Early Childhood) Identifying oneself. Learning appropriate roles and behaviors by acquiring the ability to perceive the expectations of others.

What is Stage 4 of Peplau's Personality development theory (Late childhood) Developing skills in participation. Learning the skills of compromise, competition , and cooperation with others. Establishment of more realistic view of the world and a feeling of one's place in it.

 What are the 3 levels of the Public Health Model Primary prevention, Secondary prevention, and Tertiary prevention.

Describe the Primary Prevention level It targets groups at risk and provides educational programs.

Describe the Secondary prevention level Minimizes early symptoms of illness and directed toward reducing the prevalence and duration of the illness. Accomplished through early identification of problems and initiating treatment.

Describe the Tertiary prevention level Reducing the residual defects associated with illness. Accomplished by preventing further complications and maximizing a person's level of functioning.

When does nursing care at the secondary level of prevention occur Only if the crisis intervention at the primary level has failed and the person is unable to function socially or occupationally.

Define psychobiology The study of the biological foundations of cognitive, emotional, and behavioral processes.

What are the frontal lobes of the brain responsible for Voluntary body movement, movement that permits speaking, thinking and judgement formation, and expression of feelings.

What are the parietal lobes of the brain responsible for Perception and interpretation of most sensory information.

What are the temporal lobes of the brain responsible for Hearing, short-term memory, and sense of smell.

What are the occipital lobes of the brain responsible for Visual reception and interpretation.

What is the thalamus responsible for It integrates all sensory input (except smell) on the way to the cortex. It also has some involvement in emotions and mood.

What is the hypothalamus responsible for Regulates the anterior and posterior pituitary gland and exerts control over actions of the autonomic nervous system. It also regulates appetite and temperature.

What is the limbic system responsible for

AKA the "emotional brain" and is associated with feelings of fear and anxiety; anger and aggression; love, joy, and hope; and with sexuality and social behavior.

What is the mesencephalon responsible for AKA the "midbrain". For visual, auditory, and balance reflexes.

What is the pons responsible for Regulates respiration and skeletal muscle tone.

What is the medulla responsible for Contains the vital centers that regulate heart and respiratory rate, blood pressure, and the reflexes for swallowing, sneezing, coughing, and vomiting.

What is the cerebellum responsible for Regulates muscle tone and coordination and maintains posture and equilibrium.

What is the purpose of the cell body of a neuron It contains the nucleus.

What is the purpose of the axons of a neuron To transmit impulses AWAY from the cell body.

What is the purpose of the dendrites of a neuron To transmit impulses TOWARD the cell body.

What are the 3 classes of neurons in the CNS Afferent (sensory), efferent (motor), and interneurons.

What is the function of afferent neurons To carry impulses from the outside to the CNS so the may be interpreted into various sensations.

What is the function of efferent neurons To carry impulses from the CNS to muscles and glands.

What is the function of interneurons To carry sensory or motor impulses WITHIN the CNS. They may also serve as integrators in the pathways between afferent and efferent neurons.

What are presynaptic neurons Neurons that conduct impulses toward the synapse.

What are postsynaptic neurons Neurons that conduct impulses away from the synapse.

 What are the 4 major categories of neurotransmitters Cholinergics, monoamines, amino acids, and neuropeptides.

What is the cholinergic listed in D2L Acetylcholine.

What is the function of Acetylcholine It plays a role in sleep, arousal, pain perception, movement, and memory.

What are the monoamines listed in D2L Norepinephrine, dopamine, serotonin, and histamine.

What is the function of norepinephrine It influences mood, cognition, perception, cardiovascular function, sleep, and arousal.