Unit Objectives
DSM-5-TR
● Define the overall goals and purpose of the DSM.
○ The purpose of the DSM 5 was to standardize the language for healthcare
providers and facilitate consistency in the diagnosis of mental health
disorders among clinicians.
○ A standardized reference classifying mental health disorders
■ Only for assessment/diagnosis (not tx interventions)
● Describe the structure and organization of the DSM-5-TR to maximize
clinical application.
○ Organized across the lifespan (children/neurodevelopment
adult/neurocognitive)
○ The first section is an introduction and outlines the use of the manual
○ The second section has diagnostic criteria and codes
○ The third section has emerging measures and models
● Explain the revisions in the DSM-5-TR and its applicability to clinical
practice.
○ Descriptive text
○ prevalence/risk factors/prognostic factors/culture-related diagnostic issues
○ The addition of one new diagnosis (Prolonged Grief Disorder)
● Compare DSM to ICD.
○ Harmonize the ICD with the DSM 5
○ ICD – code numbers for insurance reimbursement and statistical
monitoring
○ DSM – current diagnostic criteria
● Identify major changes including new diagnoses in the DSM-5-TR.
○ A new diagnosis is the prolonged grief disorder
○ No DSM codes anymore
PMHNP Role and Scope
● State the four key areas of focus for psychiatric mental health nurse
practitioners including physical health assessment, pathophysiology,
pharmacology, and psychotherapy.
○ Physical and psychosocial advance health assessments
○ Diagnosis of mental health disorders
, ○ Psychotherapy
○ Medication management
● Identify the core PMHNP competencies.
○ Scientific foundations, leadership, quality, practice inquiry, technology and
information literacy, policy, health delivery systems, ethics, independent
practice
● Explain the theories commonly used in psychiatric mental health.
Identify the key nursing theorist associated with each theory and his/her
specific contribution. Apply each theory to clinical practice.
○ Psychodynamic
■ Freud, Jung/ Adler
■ Conscious vs unconscious
■ Grow and understand the concepts to better treat the illness
■ Defense mechanisms--react in order to get our needs met
■ Transference and countertransference
○ Cognitive
■ Beck--human behavior is driven by thought processes, if we
change our thoughts we can change our behavior
■ Albert bandura-social learning theory
■ Self-efficacy theory
■ Cognitive and behavioral theories
○ Behavioral
■ Pavlov and Skinner, learned behavioral response
■ Thorndike learning theory
■ Problem-solving approach
○ Psychosocial
■ Main influence
● Developmental
○ Erikson’s stages of development
■ Age-based, each with its own conflict, which
concludes with it’s own resolution of the conflict
to move on to the next stage (resources are
learned for future use in future crises)
● Humanistic
○ Human potential and positives
○ Maslow's hierarchy of needs
■ Basic needs met before advanced
psychosocial needs
○ Unconditional positive regard
○ Person-centered care
● Interpersonal
, ○ Personality has energy, tensions and transformations,
and the understanding of interpersonal relationships
is an understanding of all human behavior
○ Attributed health and wellness to the ways that people
interacted
○ Emphasis on self-esteem
○ Sullivan and Pavlov
○ Biologic theories
■ Sullies physiological response distress (fight or flight)
■ Stewart's stress adaptation model (more psych-related)
○ General systems theory
■ Holistic human systems are open and cannot be understood by
examining the parts alone
■ An entity is made up of interrelated and interdependent parts
○ Change theories
■ The theory of reasoned action and planned behavior--prominent in
Motivational Interviewing
■ Transtheoretical model
● Precontemplation
○ Unaware and unlikely to take action
● Contemplation
○ Becoming aware and starting to take inventory of
pros/cons
● Preparation
○ Intention to make a change in the future and takes
small steps to changes
● Action
○ Takes action to change and sees the benefits of these
actions
● Maintenance
○ Actions to present a relapse of previous behavior
● Termination
○ No temptations and is confident that they will not
return to previous behavior
● Define the priority of concordance in PMHNP practice and compare it
with compliance and adherence.
○ Compliance is the extent to which a person’s behavior coincides with
medical instructions
○ Adherence is following the advice of healthcare professionals
○ concordance is working together with the healthcare professional to agree
on the treatment plan
DSM-5-TR
● Define the overall goals and purpose of the DSM.
○ The purpose of the DSM 5 was to standardize the language for healthcare
providers and facilitate consistency in the diagnosis of mental health
disorders among clinicians.
○ A standardized reference classifying mental health disorders
■ Only for assessment/diagnosis (not tx interventions)
● Describe the structure and organization of the DSM-5-TR to maximize
clinical application.
○ Organized across the lifespan (children/neurodevelopment
adult/neurocognitive)
○ The first section is an introduction and outlines the use of the manual
○ The second section has diagnostic criteria and codes
○ The third section has emerging measures and models
● Explain the revisions in the DSM-5-TR and its applicability to clinical
practice.
○ Descriptive text
○ prevalence/risk factors/prognostic factors/culture-related diagnostic issues
○ The addition of one new diagnosis (Prolonged Grief Disorder)
● Compare DSM to ICD.
○ Harmonize the ICD with the DSM 5
○ ICD – code numbers for insurance reimbursement and statistical
monitoring
○ DSM – current diagnostic criteria
● Identify major changes including new diagnoses in the DSM-5-TR.
○ A new diagnosis is the prolonged grief disorder
○ No DSM codes anymore
PMHNP Role and Scope
● State the four key areas of focus for psychiatric mental health nurse
practitioners including physical health assessment, pathophysiology,
pharmacology, and psychotherapy.
○ Physical and psychosocial advance health assessments
○ Diagnosis of mental health disorders
, ○ Psychotherapy
○ Medication management
● Identify the core PMHNP competencies.
○ Scientific foundations, leadership, quality, practice inquiry, technology and
information literacy, policy, health delivery systems, ethics, independent
practice
● Explain the theories commonly used in psychiatric mental health.
Identify the key nursing theorist associated with each theory and his/her
specific contribution. Apply each theory to clinical practice.
○ Psychodynamic
■ Freud, Jung/ Adler
■ Conscious vs unconscious
■ Grow and understand the concepts to better treat the illness
■ Defense mechanisms--react in order to get our needs met
■ Transference and countertransference
○ Cognitive
■ Beck--human behavior is driven by thought processes, if we
change our thoughts we can change our behavior
■ Albert bandura-social learning theory
■ Self-efficacy theory
■ Cognitive and behavioral theories
○ Behavioral
■ Pavlov and Skinner, learned behavioral response
■ Thorndike learning theory
■ Problem-solving approach
○ Psychosocial
■ Main influence
● Developmental
○ Erikson’s stages of development
■ Age-based, each with its own conflict, which
concludes with it’s own resolution of the conflict
to move on to the next stage (resources are
learned for future use in future crises)
● Humanistic
○ Human potential and positives
○ Maslow's hierarchy of needs
■ Basic needs met before advanced
psychosocial needs
○ Unconditional positive regard
○ Person-centered care
● Interpersonal
, ○ Personality has energy, tensions and transformations,
and the understanding of interpersonal relationships
is an understanding of all human behavior
○ Attributed health and wellness to the ways that people
interacted
○ Emphasis on self-esteem
○ Sullivan and Pavlov
○ Biologic theories
■ Sullies physiological response distress (fight or flight)
■ Stewart's stress adaptation model (more psych-related)
○ General systems theory
■ Holistic human systems are open and cannot be understood by
examining the parts alone
■ An entity is made up of interrelated and interdependent parts
○ Change theories
■ The theory of reasoned action and planned behavior--prominent in
Motivational Interviewing
■ Transtheoretical model
● Precontemplation
○ Unaware and unlikely to take action
● Contemplation
○ Becoming aware and starting to take inventory of
pros/cons
● Preparation
○ Intention to make a change in the future and takes
small steps to changes
● Action
○ Takes action to change and sees the benefits of these
actions
● Maintenance
○ Actions to present a relapse of previous behavior
● Termination
○ No temptations and is confident that they will not
return to previous behavior
● Define the priority of concordance in PMHNP practice and compare it
with compliance and adherence.
○ Compliance is the extent to which a person’s behavior coincides with
medical instructions
○ Adherence is following the advice of healthcare professionals
○ concordance is working together with the healthcare professional to agree
on the treatment plan
