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BIPC Exam 1
Definitions, MSE
106
Other
Graduate
04/18/2010

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Term
Anxiety
Definition
Feeling of apprehension caused by anticipation of danger, which may be internal or external
Term
Blocking
Definition
Abrupt interruption in train of thinking before a thought or idea is finished; after a brief pause, the person indicates no recall of what was being said or was going to be said (also known as thought deprivation or increased thought latency). Common in schizophrenia and severe anxiety.
Term
Blunted affect
Definition
Disturbance of affect manifested by a severe reduction in the intensity of externalized feeling tone; one of the fundamental symptoms of schizophrenia, as outlined by Eugen Bleuler.
Term
Circumstantiality
Definition
Disturbance in the associative thought and speech processes in which a patient digresses into unnecessary details and inappropriate thoughts before communicating the central idea. Observed in schizophrenia, obsessional disturbances, and certain cases of dementia. See also tangentiality.
Term
Compulsion
Definition
Pathological need to act on an impulse that, if resisted, produces anxiety; repetitive behavior in response to an obsession or preformed according to certain rules, with no true end in itself other than to prevent something from occurring in the future
Term
Constricted affect
Definition
Reduction in intensity of feeling tone that is less severe than that of blunted affect.
Term
Delusion
Definition
False belief, based on incorrect inference about external reality, that is firmly held despite objective and obvious contradictory proof or evidence and despite the fact that other members of the culture do not share the belief.
Term
Delusion of control
Definition
False belief that a person's will, thoughts, or feelings are being controlled by external factors.
Term
Delusion of grandeur
Definition
Exaggerated conception of one's importance, power, or identity
Term
Delusion of persecution
Definition
False belief of being harassed or persecuted; often found in litigious patients who have a pathological tendency to take legal action because of imagined mistreatment. Most common delusion.
Term
Delusion of reference
Definition
False belief that the behavior of others refers to oneself or that events, objects, or other people have a particular and unusual significance, usually of a negative nature; derived from idea of reference, in which persons falsely feel that others are talking about them.
Term
Delusion of self-accusation
Definition
False feeling of remorse and guilt. Seen in depression with psychotic features.
Term
Depersonalization
Definition
Sensation of unreality concerning oneself, parts of oneself, or one's environment that occurs under extreme stress or fatigue. Seen in schizophrenia, depersonalization disorder, and schizotypal personality disorder.
Term
Echolalia
Definition
Psychopathological repeating of words or phrases of one person by another; tends to be repetitive and persistent. Seen in certain kinds of schizophrenia, particularly the catatonic types.
Term
Flat affect
Definition
Absence or near absence of any signs of affective expression.
Term
Flight of ideas
Definition
Rapid succession of fragmentary thoughts or speech in which content changes abruptly and speech may be incoherent. Seen in mania.
Term
Hallucination
Definition
False sensory perception occurring in the absence of any relevant external stimulation of the sensory modality involved.
Term
Idea of influence
Definition
beliefs about another person or force controlling some aspect of one’s behavior
Term
Idea of reference
Definition
Misinterpretation of incidents and events in the outside world as having direct personal reference to oneself; occasionally observed in normal persons, but frequently seen in paranoid patients. If present with sufficient frequency or intensity or if organized and systematized, they constitute delusions of reference.
Term
Insight
Definition
Conscious recognition of one's own condition. In psychiatry, it refers to the conscious awareness and understanding of one's own psychodynamics and symptoms of maladaptive behavior; highly important in effecting changes in the personality and behavior of a person.
Term
Judgment
Definition
Mental act of comparing or evaluating choices within the framework of a given set of values for the purpose of electing a course of action. If the course of action chosen is consonant with reality or with mature adult standards of behavior, judgment is said to be intact or normal; judgment is said to be impaired if the chosen course of action is frankly maladaptive, results from impulsive decisions based on the need for immediate gratification, or is otherwise not consistent with reality as measured by mature adult standards.
Term
Labile affect
Definition
Affective expression characterized by rapid and abrupt changes, unrelated to external stimuli.
Term
Loosening of associations
Definition
Characteristic schizophrenic thinking or speech disturbance involving a disorder in the logical progression of thoughts, manifested as a failure to communicate verbally adequately; unrelated and unconnected ideas shift from one subject to another. See also tangentiality.
Term
Neologism
Definition
New word or phrase whose derivation cannot be understood; often seen in schizophrenia. It has also been used to mean a word that has been incorrectly constructed but whose origins are nonetheless understandable (e.g., headshoe to mean hat), but such constructions are more properly referred to as word approximations.
Term
Obsession
Definition
Persistent and recurrent idea, thought, or impulse that cannot be eliminated from consciousness by logic or reasoning; involuntary and ego-dystonic. See also compulsion.
Term
Paranoid delusions
Definition
Includes persecutory delusions and delusions of reference, control, and grandeur.
Term
Perseveration
Definition
(1) Pathological repetition of the same response to different stimuli, as in a repetition of the same verbal response to different questions. (2) Persistent repetition of specific words or concepts in the process of speaking. Seen in cognitive disorders, schizophrenia, and other mental illness. See also verbigeration.
Term
Phobia
Definition
Persistent, pathological, unrealistic, intense fear of an object or situation; the person may realize that the fear is irrational but, nonetheless, cannot dispel it.
Term
Restricted affect
Definition
Reduction in intensity of feeling tone, which is less severe than in blunted affect, but clearly reduced. See also constricted affect.
Term
Stupor
Definition
(1) State of decreased reactivity to stimuli and less than full awareness of one's surroundings; as a disturbance of consciousness, it indicates a condition of partial coma or semicoma. (2) In psychiatry, used synonymously with mutism and does not necessarily imply a disturbance of consciousness; in catatonic stupor, patients are ordinarily aware of their surroundings.
Term
Tangentiality
Definition
Oblique, digressive, or even irrelevant manner of speech in which the central idea is not communicated.
Term
Axis I ― Clinical Disorders:
Definition

delirium,dementia & cognitive disorders

 

Axis?

Term
Axis I ― Clinical Disorders:
Definition

mental disorder due to general medical condition

 

 

Axis?

Term
Axis I ― Clinical Disorders:
Definition

substance related disorders

 

 

Axis?

Term
Axis I ― Clinical Disorders:
Definition

schizophrenia & other psychotic disorders

 

 

Axis?

Term
Axis I ― Clinical Disorders:
Definition

mood disorders

 

Depressive disorders: major depressive disorder, postartum depression, season affective disorder

 

Bipolar disorders

 

 

 

Axis?

Term
Axis I ― Clinical Disorders:
Definition

anxiety disorders

 

 

Axis?

Term

Axis I ― Clinical Disorders:

 

 

 

 

 

Somatoform disorder (also known as Briquet's syndrome) is a mental disorder characterized by physical symptoms that mimic physical disease or injury for which there is no identifiable physical cause[1]. The symptoms that result from a somatoform disorder are due to mental factors. In people who have Somatoform disorder, medical test results are either normal or don't explain the person's symptoms.

Definition

somatoform disorders

 

 

Axis?

Term

Axis I ― Clinical Disorders:

 

 

 

Factitious disorders are conditions in which a person acts as if he or she has a physical or mental illness when he or she is not really sick. ...

Definition

factitious disorders

 

 

Axis?

Term
Axis I ― Clinical Disorders:
Definition

dissociative disorders

 

 

Axis?

Term
Axis I ― Clinical Disorders:
Definition

sexual & gender identity disorders

 

 

Axis?

Term
Axis I ― Clinical Disorders:
Definition

eating disorders

 

 

Axis?

Term
Axis I ― Clinical Disorders:
Definition

sleep disorders

 

 

Axis?

Term
Axis I ― Clinical Disorders:
Definition

impulse control disorders

 

 

Axis?

Term
Axis I ― Clinical Disorders:
Definition

adjustment disorders

 

 

Axis?

Term

Axis I ― Clinical Disorders:

 

Definition

other conditions that may be a focus of clinical attention

 

axis?

Term
Axis II ― Personality Disorders & MR:
Definition

Paranoid

 

axis?

Term
Axis II ― Personality Disorders & MR:
Definition

Schizoid

 

axis?

Term
Axis II ― Personality Disorders & MR:
Definition

Schizotypal

 

axis?

Term
Axis II ― Personality Disorders & MR:
Definition
Antisocial

axis?
Term
Axis II ― Personality Disorders & MR:
Definition
Borderline

Axis?
Term

Axis II ― Personality Disorders & MR:

 

 

Histrionic personality disorder (HPD) is characterized by a pattern of excessive emotionality and attention-seeking, including an excessive need for approval and inappropriate seductiveness, usually beginning in early adulthood. These individuals are lively, dramatic, enthusiastic, and flirtatious.

Definition
Histrionic Axis?
Term
Axis II ― Personality Disorders & MR:
Definition
Narcissistic

Axis?
Term
Axis II ― Personality Disorders & MR:
Definition
Avoidant

Axis?
Term

Axis II ― Personality Disorders & MR:

 

 

 

Dependent personality disorder (DPD), formerly known as asthenic personality disorder, is a personality disorder that is characterized by a pervasive psychological dependence on other people. The difference between a 'dependent personality' and a 'dependent personality disorder' is somewhat subjective, which makes diagnosis sensitive to cultural influences such as gender role expectations.

Definition
Dependent Axis?
Term
Axis II ― Personality Disorders & MR:
Definition
Obsessive-Compulsive

Axis?
Term
Axis II ― Personality Disorders & MR:
Definition
Personality Disorder NOS

Axis?
Term
Axis II ― Personality Disorders & MR:
Definition
Mental Retardation

Axis?
Term
Axis III ― Medical Conditions:
Definition
*Phys condition could be causative—cirrhosis that leads to delirium.

Axis?
Term
Axis III ― Medical Conditions:
Definition
*Phys condition as a result of a mental disorder—gastritis 2ndary to ETOH abuse

Axis?
Term
Axis III ― Medical Conditions:
Definition
*Any phys condition unrelated to Ment disordr

Axis?
Term
Axis III ― Medical Conditions:
Definition
*Mental disordr due to general dcondition from Axis I, and med condition is listed on axis ______
Term
Axis IV ― Psychosocial & Environmntl Probs:
Definition

Problems with primary support group

 

Axis?

Term
Axis IV ― Psychosocial & Environmntl Probs:
Definition
Problems related to social environment

Axis?
Term
Axis IV ― Psychosocial & Environmntl Probs:
Definition
Abuse that doesn’t meet PTSD criteria

Axis?
Term
Axis IV ― Psychosocial & Environmntl Probs:
Definition
Educational problems

Axis?
Term
Axis IV ― Psychosocial & Environmntl Probs:
Definition
Occupational problems

Axis?
Term
Axis IV ― Psychosocial & Environmntl Probs:
Definition
Housing problems

Axis?
Term
Axis IV ― Psychosocial & Environmntl Probs:
Definition
Economic

Axis?
Term
Axis IV ― Psychosocial & Environmntl Probs:
Definition
Problems with access to health care services

Axis?
Term
Axis IV ― Psychosocial & Environmntl Probs:
Definition
Problems related to interaction with legal system

Axis?
Term
Axis IV ― Psychosocial & Environmntl Probs:
Definition
Other psychosocial and environmental problems

Axis?
Term
Axis V ― Global Assessment of Functioning
Definition
Does not include impairment of function due to phys or envirnmntl limitations.

Axis?
Term
Axis V ― Global Assessment of Functioning
Definition
Rates overall functioning on a 0-100 scale: Axis?
Term
80-100 on GAS
Definition
transient, min symptoms on GAS? (## - ##)
Term
51-70 on GAS
Definition
is moderate on GAS (## - ##)
Term
< 50 on GAS
Definition
severe on GAS (##)
Term
Hope: Trust vs. Mistrust development

“Good enough” mother vs. helicopter parent
Definition
Birth ~
Infants
Term
Will: Autonomy vs. Shame & Doubt

Potty training, positive reinforcement. Embarrassment and shame (due to potty training transition)
Definition
~ 18m - 3yrs
Toddlers
Term
Purpose: Initiative vs. Guilt

Initiative (purpose), mastery of locomotion and language skills
Definition
~ 3yrs
Preschool, 4-6yrs
Term
Competence: Industry vs. Inferiority

About confidence, reassurance
Definition
~ 5yrs
Childhood, 7-12yrs
Term
Fidelity: Identity vs. Role Confusion

Puberty
Formation of cliques → identity development, community development
“fidelity ”, honor partnerships, social (cliques) and physiological changes.
Definition
~ 13yrs
Adolescents, 13-19yrs
Term
Love: Intimacy vs. Isolation

Loyalty and fidelity…connection to other human beings
“to love and to work ”
Definition
~20's
Young Adults, 20-34yrs
Term
Care: Generativity vs. Stagnation

Giving back to the next generation; How can we make it better for others
“care ”concern for guiding the next generation
Definition
~40's
Middle Adulthood, 35-60yrs
Term
Wisdom: Integrity vs. Despair

‘Old and wise’ caricature
Being at peace with the finality of life
Correlation between the infant:
Infant…basis to not fear life
Old…not regretting life, fearing death
Definition
~60's
Seniors, 65 yrs onwards
Term
o Psychiatric Pertinent Review of Symptoms (positive and negative findings)
Definition
The following are part of what?
- Mood
- Anxiety
- Psychosis
- Substance Abuse
- Physical, emotional, sexual abuse
o Sexual abuse is always in the HPI
- Eating disorder
- Safety/ suicidal or homicidal ideation****
Term
- Current and prior diagnoses and treatments
o Medications, therapy, duration, what worked, s/e
- Suicide attempts (total, first, most recent, lethality)****IN HPI
- Violence associated with Illness (number, severity, legal actions)****IN HPI
- Hospitalizations
o Voluntary, involuntary
o How may, first, most recent
o List as most recent to most distant in H&P write up
Definition
What you need to ask about in the Psych Hx
Term
o 1st degree relative = ↑ risk
o Suicide attempts, substance abuse, what meds worked for them
o Medical issues―HTN, CA, etc
o Psychiatric illness, hospitalizations, treatment, alcohol or substance abuse, antisocial behavior
Definition
What you need to know in the Psych FH
Term
o Problems during pregnancy or birth
o Developmental delays
o Home life from childhood through adolescence―parents, siblings, key role models
o School performance, conduct, legal
o Peer relationships, dating
o History of trauma/abuse
o EtOH, drugs, tobacco
Definition
What you need to know in the Developmental Hx
Term
General―ALWAYS IN THE HPI

HEENT, skin, neck/nodes, respiratory, CV, GI, GU/reproductive, musculoskeletal/back/extremities, endocrine, neuro, hematologic
Definition
Psych ROS
Term
thought content
Definition

The following are examples of abnormal _____________. compulsions

delusions

feelings of depersonalization

hallucinations

obsessions

phobias

suicidal and homicidal ideation

Term

thought process

 

 

**Also part of speech abnormalities**

Definition

the following are examples of abnormal __________________

 

blocking

loosening of associations

flight of ideas

neologism

echolalia

preservation

Term
• Remote: birthdays, jobs held, past historical events (are pt’s “history”, PMH reliable, consistent, rational)
• Recent: events of the day
• Immediate Recall or New learning ability: give the pt 3-4 words and ask them to repeat after 3-5 minutes (Red, table, broadway)
Definition
3 parts of recall (memory)
Term
Serial 7s

Say “WORLD” and spell it forward and backwards
Definition
How do you test Attention / Concentration?
Term
• Time: time of day, day of week, month, season, date and year
• Place: home, name of hospital, city and state
• Person: patient’s own name, names of relatives
• Purpose: does the patient know why they are here
Definition
Components of "Orientation" (4)
Term
o Lethargy: drowsy, desire to sleep

o Confusion: disoriented in relation to time, place, or person

o Stupor: lack of reaction to surroundings. (1) State of decreased reactivity to stimuli and less than full awareness of one's surroundings; as a disturbance of consciousness, it indicates a condition of partial coma or semicoma. (2) In psychiatry, used synonymously with mutism and does not necessarily imply a disturbance of consciousness; in catatonic stupor, patients are ordinarily aware of their surroundings.

o Comatose: profound unconsciousness
Definition
Levels of Alertness: (4)
Term
Affect
Definition
The following are abnormalities of ___________.

constricted
blunted
flat
inappropriate
liable
incongruent
restricted
Term
Appearance
Attitude toward examiner
Speech Characteristics
Overt behavior and psychomotor activity
Definition
components of the general description (MSE)
Term
1.) General Description: Appearance, attitude toward examiner, speech characteristics, overt behavior and psychomotor activity

2.) Mood and Affect
3.) Alertness
4.) Orientation
5.) Attention/Concentration
6.) Calculations
7.) Recall (memory)
8.) Thought process
9.) Thought content
10.) Abstract thought
11.) Insight and judgment
12.) Impulsivity
13.) Reliability
Definition
Components of the MSE (13!)
Term
• Desire―libido; cx by sexual fantasies; reflects one’s motivations, drives, and personality
• Excitement―arousal; brought on my psychological or physical stimulation
• Orgasm―peaking sexual pleasure
• Resolution―post-orgasm
Definition
DSM IV stages of sexual response
Term
• Excitement―arousal; brought on my psychological or physical stimulation
• Plateau―moments just before orgasm (premature ejaculation)
• Orgasm―peaking sexual pleasure
• Resolution―post-orgasm
Definition
Masters and Johnson stages of sexual response cycle
Term
SSRI (libido, ED, ∅ orgasm/ejaculation)

beta-blockers & alpha-blockers (ED, libido)
anti-ACH (dryness)
Definition
Drugs that cause ED, decreased libido
Term
• Pedophilia―most common, desire for pre-pubescent <16yrs + 5 yrs age difference
o 90% are heterosexual (male)
• Exhibitionism―genital exposure, mainly female(girl) victims
• Fetishism―arousal from object
• Frotturism―non sexual touching or rubbing someone
• Masochism―humiliation, beater, suffer
• Sadism―derivation of watching pain or inflicting it on others
• Voyeurism―watching people disrobe
• Transcestic fetishism―arousal from x-dressing, distress to individual
Definition
Paraphilias

most common?
_____ = genital exposure
_____ = arousal from object
_____ = non-sexual touching or rubbing on somone
_____ = enjoying humiliating, beating, or suffering
____= derivation of watching pain or inflicting it on others
____= watching people disrobe
____= arousal from x-dressing
Term
o Bi-gender: identity encompasses both male and female
o Queer: identity is neither male or female
o Transgender: gender identity/expression/behavior is different from those associated with assigned sex at birth (transsexuals, cross-dressers, androgynous people, genderqueers, non-conforming)
o Intersex: hermaphrodite
• Turner’s syndrome: __X, female body
• Klinefelter’s syndrome: XXY, male body, ↓androgens
Definition
Define:
Bi-gender =
Queer =
Transgender =
Intersex =
Turner's sundrome =
Klinefelter's syndrome =
Term
Axis I ― Clinical Disorders:
Definition

depression, anxiety disorders, bipolar disorder, ADHD, autism, phbias, schizophrenia

 

Axis?

Term

Axis II

 

 

paranoid personality disorder

schizoid personality disorder

schizotypal personality disorder

borderline personality disorder

antisocial personality disorder

narcissistic personality disorder

histrionic personality disorder

acoidant personality disorder

dependent personality disorder

obsesive-compulsive personality disorder

Definition

paranoid

schizoid

schizotypal

borderline

antisocial

narcissistic

histrionic

acoidant

dependent

obsesive-compulsive

 

Axis?

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