Maryville University NURS 661 Exam 3 Summer 2024

Maryville University NURS 661 Exam 3 Summer 2024 Who is at highest risk of suicide? Schizophrenia White, elderly men Single, never married, divorced, recently widowed Previous attempts Adolescents with depression, bullied, or family hx of suicide Who is most likely to succeed at committing suicide? What are some protective factors for suicide? Older while males Having children Religion Stronger alliances with medical providers and therapists What is lethality? What is intent? the probability that a person will successfully complete suicide Effective expectations for desire of active death What is a suicide attempt? not led to death What is suicidal ideation? Includes all willful, self-inflicted life-threatening attempts that have thinking about suicide, usually with some serious emotional and intellectual or cognitive overtones Where in the brain do we theorize violence and aggression originate? How to assess for homicidal ideation? Prefrontal cortex Do you have homicidal ideation? Who do you want to kill? How do you plan to do this? Do you have access to the means necessary? Do you intend to commit the act? What legal follow up is needed for homicidal ideation? Based on state laws Duty to warn Obsession 1. Recurrent and persistent thoughts, urges, or images that are experienced, at some t ime during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress 2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e. by performing a compulsion) Compulsion 1. Repetitive behaviors or mental acts that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly 2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation, however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive Obsessive-Compulsive Disorder (OCD) A. Presence of obsessions, compulsions, or both B. The obsessions or compulsions are time-consuming (e.g. take more than one hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance or another medical condition D. The disturbance is not better explained by the symptoms of another mental disorder PANDAS Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections OCD common co-morbid conditions Skin Picking Hair Pulling Most Common Compulsions MDD (Major depressive disorder) Checking Ordering Arranging Washing/cleaning Hand-washing Flipping lights Counting Differentiation between OCD and eating disorders Those with eating disorders will be counting calories, focused on weight loss or maintaining a specific weight Treatment for OCD Cognitive Behavioral Therapy Pharmacological Treatment for OCD First line treatment-SSRI (Luvox, fluoxetine) Second-line treatment TCA with serotonergic properties (clomipramine) SNRI or MAOI Augmentation with benzos, lithium, or Buspar DSM-5 Body Dysmorphic Disorder observed by others Preoccupation with perceived flaw on body taht is not Repetitive behaviors such as mirror checking, excessive grooming, skin picking, reassurance seeking, clothes changing Clinical significance Differentiation from eating disorder BDD common preoccupations genitalia Facial flaws Differentiation between BDD and eating disorders f low, not the entire body Differentiation between BDD and OCD BDD is more obsessed with one specific body OCD may have food rituals but not obsession on a specific body flaw Treatment for BDD Cognitive Behavioral Therapy Pharmacological treatment of BDD of patients Clomipramine and fluoxetine reduce symptoms in about 50% DSM-5 Hoarding Disorder A. Persistent difficulty discarding or parting with possessions, regardless of their actual value B. This difficulty is due to a perceived need to save the items and to distress associated with discarding them C. The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. D. The hoarding causes clinically significant distress or impairment in social, occupational, or other