Mental Health Exam 1 Chapter outlines

Week 1 day 1 Chap 2: Mental health vs illness- all about the coping Mental health- successful adaptation to stressors from internal. External environment evidenced by thought, feelings, and behaviors that are age appropriate and congruent with local/ cultural norms Mental Illness- caused by an imbalance of brain chemicals that affects neurotransmitters- depending on disorder different types are affected, unhealthy way of coping becomes chronic; have to be nonfunctioning and have symptoms tp be diagnosed Dsm-5- symptom based tool Primary diagnosis- reason of admission; comes from DSM-5 Secondary diagnosis- another problem contributing to 1st diagnosis Neurotransmitters: Dopamine- alertness: working memory, motivation, clarity Serotonin- satisfaction: learning memory, pleasure/ pain, relaxation Norepinephrine- concentration: execution, perseverance, recall memory Dopamine+ serotonin= appetite Dopamine + norepinephrine= attention Serotonin + norepinephrine= intuition Diff chemicals= different mental disorders: Gaba- relaxation transmitter= too little= anxiety disorders Norepinephrine- too little: depression, too much: schizophrenia Adrenaline- too much: anxiety disorders Epinephrine: too little depression Serotonin- too little: depression & anxiety disorders (OCD) Dopamine- too much: schizophrenia, too little: depression, tremors, muscular rigidity (parkinsons) Acetylcholine- too much: depression, too little: dementia Factors contributing: genetics; environment Week 1Day 2: Psychological theories- help us understand why Psychological therapies- treatments based on these theories Psychoanalytic theory (Sigmund Freud)- father of psychology- 1st 5 years is important; identified developmental stages; 3 structures of personality: id, go, superego (conscience)= resolve internal conflicts Application to nursing= cause of suffering, value of talk sessions, correct inappropriate learning patterns Theory of psychosocial development (Erik Erikson)- influence of social processes on development of personality; Application to nursing: personalized care Interpersonal theory (Harry Stack Sullivan)- individual behavior and personality are the direct result of interpersonal relationships Humanistic theory (Maslow)- helps determine priority SEA- SAFETY, EXPRESS FEELINGS, ASSIST Chapter 18 Behavioral therapy- goal is to modify maladaptive behavior by reinforcing more adaptive behavior 22 3main ways to change abnormal behavior: 1.Modelling- learning of new behaviors through imitating behavior of other= lead by example to patients; demonstrate correct & appropriate behavior= demonstration and examples 2. operant conditioning- law of effect- use of positive/ negative reinforcement= reward system matic desensitization- GRADUAL EXPOSURE- commonly used in anxiety therapy; gradually introduce patients into their fears = taught techniques and then exposed Others: Aversion therapy- punishment as consequence for maladaptive behavior Meditation, guided imagery, muscle relaxation, biofeedback Flooding- exposing client to a great deal of thinks that trigger her to tone down anxiety Response prevention- prevent performance of a compulsive behavior Thought stopping- yell stop and replace bad aggressive thoughts into positive until you can say the word stop in your head (agrressive / compulsive behavior) Chapter 19 Cognitive therapy (aaron beck)- assists clients to identify negative thoughts, find out the reason why and develop supportive ideas that replace negative thoughts - Limited time, - Effective for: anxiety, depression, eating disorders - Works on thoughts, emotions and behavior (what we think affects what we feel and it affects how we act) Cognitive behavioral therapy steps: (CBT) 1. Identifies distortions 2. Examines cause for distortions 3. Reframes thinking; replaces with more realistic thoughts 4. Learn to use healthy coping mechanisms to not return to thought distortions Dialectical Behavior Therapy (DBT)- effective for patients who are chronically suicidal or with borderline disorder- helps cope with extremely stressful situations, focused on emotion Mindfulness- living in the present moment Regulating emotions- reduce intensity of emotional pain Distress tolerance- learn to defuse stressful or painful situations Interpersonal effectiveness- understand how to set boundaries and express needs Cognitive therapy includes: Journaling assertiveness training- express feelings & solve problems in a non-aggressive manner monitoring thoughts- aware of negative thinking Nurses role: reinforce; make sure they are going, pick up abnormal behavior, education, teaching Chapter 12 Milieu therapy- therapeutic community- manipulate environment so all aspects of client’s hospital experience are considered therapeutic Milieu consists of patients, environment and staff 1. Safety check 2. No contraband- metals, glass, strings, utensils, garbage bag, coins, purses, no phone with cords lighters, alcohol, cigarretes, mouthwash, hairspray, necklaces, shoelaces, knives. Razors, no pills, bra w/ wires 3. Locked doors 4. Interdisciplinary team 5. Patient identifiers 6. Calm environment – quiet, music, lighting, homey environment, 7. Monitor visitors 8. Schedule/ structure 9. Group therapy 10. Nurses station visible