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MHA 707 CH 11/MH 707- EXAM 1. module 1-2 questions and answers
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MHA 707 CH 11/MH 707- EXAM 1. module 1-2 questions and answers
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MHA 707 CH 11/MH 707- EXAM 1. module1-2 questions and answers
section 1 - DSM-5 basics: introduction, use of the manual, cautionary statement on
forensic use
section II - DSM-5 diagnostic criteria and codes
Section III - DSM-5 emerging measures and models, assessment measures, cultural
formulation, alternate model for personality disorders, conditions for further study
What section would give you a clinical picture of a disorder - section II
DSM-5 disorder categories - "Depressed Patients Sound Anxious, So Claim
Psychiatrists"
depression and other mood disorders, psychotic disorders, substance abuse disorders,
anxiety disorders, somatic disorders, cognitive disorders, personality disorders
DSM-5 Purpose - provide communication amongst providers to treat different disorders,
provide standards of each disorder, and provide a clinical picture of the individual
Vanderbilt ADHD Assessment scale - assessment tool for attention deficit hyperactive
disorder that is available free online
Techniques used to elicit information with a reluctant patient - open ended questions,
continuation techniques, shift to neutral ground, schedule second interview
Continuation techniques - " go on", Really?. wow?"
HPI Crisis Approach - "Why now", "why is this a crucial point in the person's life", focus
on 1-4 week period when the crisis occured
HPI Syndrome Approach - begin questioning by ascertaining when the patient first
remembers signs of illness. Ensuing questions track the course of the illness through
months or years, arriving at the present
,HPI chronological narrative - when patients jumps into a chronologic narrative of their
problems; your "scouting" period
HPI launch into diagnostic questions - when a patient mentions a type of mood,
immediately assess for presence of the diagnostic criteria
HPI current and premorbid level of functioning - assess overall functioning by asking
THREE basic aspects of life: love, work, and fun
common precipitants of psychiatric syndromes - arguments with friends or family,
rejection or abandonment, death or major illness of a loved one, anniversary of a
negative event, major medical illness or age related deterioration in functioning,
stressful events at work or school, mental health clinician going on vacation, medication
noncompliance, substance abuse
Mature defenses - suppression, altruism, sublimation, humor
suppression - emotion remains conscious but is suppressed
altruism - suppressing the emotion by doing something nice for others
sublimation - transmuting the emotion into a productive and socially redeeming
endeavor (ill start immediately on a book about how to cope with rejection)
Neurotic Defenses - Denial, repression, reaction formation, displacement, rationalization
Repression - stuffing the emotion out of conscious awareness
reaction formation - forgetting the negative emotion by transforming it into its opposite
(We've become close friends since this happened, he is really a wonderful person)
Displacement - displacing the emotion from its original object to something or someone
else (to someone or something less threatening)
Rationalization - inventing a convincing, but false, reason why you are not bothered
Immature Defenses - Lead to more severe distress and often have a negative impact on
other people
Passive aggression, acting out, dissociation, projection, splitting
, Dissociation - dissociating instead of feeling pain (memory of him is very hazy)
projection - disavowing the anger and ascribing it to the object of the anger
Splitting - defining the rejecting person as being all bad versus having seen him as all
good before the rejection (black or white, all or nothing thinking)
Psychotic defenses - denial of external reality ( he never left me), Distortion of external
reality (he didnt leave me he went off on a business trip)
CAGE - questionnaire that is a screening tool to assess alcoholic intake
Components of History and physical - identifying factors
chief complaint (patients own words)
HPI
past psychiatric history
substance use
past medical history
family history (health, tradition, beliefs)
social/developmental history
Psychiatric review of symptoms- neuro s/s
MSE
Physcial exam (Neuro focused)
Laboratory tests
Aims Scale - used to assess for EPS when on antipsychotics
SAF-T - suicide risk assessment tool
CAMS - suicide risk assessment tool; collaborative assessment and management for
suicidal behaviors; collaborative with patient
Suicide Risk Factors - suicidal behavior, hx of attempts, aborted suicide attempts, self
injurious behavior, current/past psychiatric disorders, mood disorders, psychotic
disorders, substance abuse, ADHD, PTSD, Cluster B personality disorders, conduct
disorders, comorbidity, recent onset of illness
Key symptoms for Suicide Risk - anhedonia, impulsivity, hopelessness, anxiety and
panic, insomnia, command hallucinations, family history of attempts, psychiatric
disorders requiring hospitalization
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