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Psychiatric and Cognitive Disorders
Chapter 10
74
Other
Post-Graduate
06/16/2014

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Term
Consciousness
Definition
State of awareness
A and O times 4 person place time & situation
Delirium, Confusion, Disorientation, Sundowning
Term
Attention
Definition
Ability to remain focued
Distractibility
Selective inattention
Hypervigilance
Trance
Term
Emotion
Definition
Feeling with affect and mood w/ physical components
Observable Components
Pervasive and sustained emotion
Anxiety
Fear
Physiological disturbances
Term
Motor Behavior
Definition
Impulses, drives, wishes, motivations, cravings
Echopraxia
Catatonia
Stereotypy
Psychomotor
yperactivity
Psychomotor
Agression
Actiong Out
Akathisia
Ataxia
Term
Thinking
Definition
Goal directed, reasoned
Disturbances are:
Circumstantiality
Tangentiality
Perseveration
Flight of idea
Thought Blocking
Thought of Disturbances in content
Delusions
compulsions
Obsessions
Phobias, hypochondria
Term
Speech
Definition
Expression of ideas, thoguhts, feelings
Disturbances in speech
Pressured
Poverty
Nonspontaneous
Stuttering
Perseveration
Language Disturbances
Expressive Aphasia (Broca's)
Receptive Aphasia (Wernicke's)
Nominal Aphasia (amnesia)
Global Aphasia
Term
Perception
Definition
Interpreting Sensory Information
Disturbances of perception
Halucinations
Illusions
W/ A Cognitive Disorder
Apraxia
Adiadochokinesia, visual agnosia, agnosia, astereognosis
Disturbances with conversion and dissociative -
Depersonalization, derealization, fugue, dissociative identify
Dissociation
Term
Agnosia-
Definition
Cannot understand sensory input
Term
Astereognosis -
Definition
Cannot identify by touch
Term
Visual Agnosia -
Definition
cannot recognize people or ojbects
Term
Apraxia -
Definition
Cannot carrow out motor tasks w/ motor and sensory intact.
Term
Adiadochokinesia
Definition
Inability to perform rapidly alternating movements
Term
Depersonalization
Definition
subjective sense of being ureal or inanimate
Term
Derealization
Definition
subjective sense that the environment is unreal
Term
Fugue
Definition
State of depersonalization with relocation, new identity
Term
Dissociative identify
Definition
appearance of two or more personalities
Term
Dissociation
Definition
separation of a group of mental processess from test of activity.
Term
Immediate Memory
Definition
recall distant past recall within seconds
Term
Amnesia Recent memory
Definition
Inability to recall
recall past few days
Term
recent past memory
Definition
recall past few month
Term
remote memory
Definition
recall distant past
Term
Amnesia
Definition
cannot recall cuz or organic/emotional function
Retrograde - cannot recall prior to event
Term
Psychiatric Disorder Diagnosis by psychiatrist
Definition
History and physical status
Clinical interview and mental status
Clinical observation
Appearance, Speech, Actions, Thoughts
Term
Mental Status Examination
Definition
General description of person
Mood and affect
Speech
Perceptual disturbances
Tought
Sensorium and Cognition
Impulse control
Judgment and insight
Reliability
Term
DSM V Criteria
Definition
Axis I - clinical disorders
Axis II - personality disorders and intellectual disorders
Axis III - general medical conditions
Axis IV - psychosocial and environmental problems
Axis V - provides a Global Assessment of Functioning 0-100 GAF
Term
Schizophrenia
Definition
Criterian A - (2 or more) Delusions,, hallucination, disorganized speech, catatonic behavior, negative symptoms
Criterian B - one or more - work relations, self care
Criterion C - continuous sign of illness for 6 months or more
Positive Symptoms - excess of normal function
Negative symptoms - loss of emotion, thoughts speech, motivation, inability to relate, iniative.
Term
Paranoid type Schizophrenia
Definition
1 or more delusions
auditory hallucinations
fewer negative symptoms
Term
Disorganized type Schizophrenia
Definition
regression in primitive disorganized behavior
Term
Catatonic type Schizophrenia
Definition
Sever disturbances in motor behavior stupor, negativism, posturing
Term
Undifferentiated Type

Residual Type
Definition
Not in one category

Evidence but does not fit criteria
Term
Schizophreniform
Definition
symptoms last 1-6 months
Term
Schizoaffective disorder
Definition
Uninterrupted period of illneess with depression and manic
Term
Delusional disorder
Definition
delusions mainly
Term
brief psychotic disorder
Definition
symptoms 30 days with stress
Term
Functional deficits of Schizophrenia
Definition
cognitive-perceptual
social interaction skills
sensory processing
socially inappropriate
communication skills
cognitive function, self care, etc.
Term
Medical Management of Schizophrenia
Definition
Pharmacology
Traditional antipsychotic medications
Thorazine, Proliin, Haldol, Navane,
Atypical antipsychotics
Clozaril, risperdal, zyprexa, seroquel, geodon, and abilify
Term
Mood Disorders
Definition
Major depressive disorder
Bipolar I
Bipolar II
Term
Manic Episode
Definition
Period of abnormal, elevated, expansive, irritable, mood lasting more than one week.
Inflated self-esteen, decreased sleep, more talkative, thoughts racing, distractibility, goal-directed activity, excessive involvement in pleasurable activities.
Behaviors, failure to recognize illness, suggestive dress, excessive spending, irritable, suicidal, poor judgement, substance abuse
Medical management
Mood stabilizers and anticonvulsants
OT: Limit setting, fears of losing control, release of excess energy, education
Term
Major Depressive Episode
Definition
Two week period of depressed mood of loss of pleasure
Depressed mood, interest, weight loss/gain, insomnia/ agitation, fatigue, guilt, unable to concentrate, death, suicide, social interactions, self-destructive behavior, tearful, anxiety, hopelessness.
Medical management - Antidepressents, MAOIs,
Psychotherapy
CBT
ECT
OT: safe environment, closely monitored, careful when depression begins to lift.
Term
Substance-related disorders
Definition
Substance use disorders
Substance-induced disorders, - intoxication, withdrawal, anxiety, affective and psychotic disorders
Tolerance and Withdrawal
OT: works with team on actual skills and deficits, expectations, plans,
opeing, communication, social participation, work, leisure, life patterns, Support groups,e tc.
Term
Anxiety Disorders
Definition
Panic, Phobia's, OCD PTSD, Acute stress disorder, generalized anxiety disorder,
Medical management - anxiolytic medications, antidepressent meds, anti-obsessional meds, hypnotic meds
OT: Skills and CBT, relaxation, stress management, promote self-efficacy
Term
Personality Disorders
Definition
characteristics that deviate from accepted norms in cognition, affect, impulse control and interpersonal relating, behavior is inflexible and maladaptive, onset late childhood or adolescence
Medical management: Medications
OT: identify issues, behavioral change, DBT, CBT, Coping
Term
Cluster A personality disorder
Definition
Paranoid, schizoid, and schizotypal
odd, eccentric
Term
Cluster B personality disorder
Definition
Antisocial borderlie, narcissistic, dramatic, erratic
Term
Cluster C personality disorder
Definition
Avoidant, dependent, OCD, anxious or fearful
Term
OCD
Definition
obsessions, recurrent, persistive thoughts, behaviors repetitive
Compulsions are timeconsuming
Term
PTSD
Definition
re-experiencing extemely traumatic event
avoidance of stimuli associated with event
Term
Acute stress disorder
Definition
Similiar to PTSD, but immediate, symptoms don't exist beyond one month
Term
Generalized anxiety disorder
Definition
Consists of 6 months of persistent and excessive unfocused anxiety and worry
Term
Paranoid personality disorder -
Cluster A
Definition
Suspiciouness and mistrust of people, don't accept responsibility, irritable, angry
Term
Schizoid personality Disorder -
Cluster A
Definition
Social withdrawal
Intrversion, eccentric
Term
Schizotypal personality disorder
Cluster A
Definition
Odd or strange thinking, peculiar ideals, derealization
Term
Antisocial personality disorder -
Cluster B
Definition
antisocial or criminal acts, inability to conform, no regard for safety or others
Term
Borderline personality disorder -
Cluster B
Definition
Unstable affect, mood, behavior, fear of abandonment, self-destructive behavior,self-mutilating behavior, history of trauma
Term
Histrionic personality disorder -
Cluster B
Definition
colorful, dramatic extroverted, emotional personal, inability to maintain, deep long lasting attachments
Term
Narcissistic personality disorder -
Cluster B
Definition
heightened sense of self-importance, grandiose feeling
Term
Avoidant personality disorder -
Cluster C
Definition
extreme sensitivity to rejection, socially withdrawan, good companions, need uncritical acceptance, has inferiority complex
Term
Dependent personality disorder -
Cluster C
Definition
need to have others in their lives, lack self-confidence, experience discomfort when alone
Term
Obsessive-compulsive personality disorder -
Cluster C
Definition
emotional constriction, perseverance, stubborness, pattern of perfectionism
Is not OCD
Term
Personality Disorder NOS
Cluster C
Definition
Passive Aggressive
Defpressive
Sadomasochistic
Sadistic
Term
Cognitive Disorders
Definition
Delirium, dementia (aphasia, apraxia, agnosia, executive funtion), Amnesic disorders
OT: Maintenance of quality of life through activity and adaptation and environmental modification
Term
Anorexia nervosa
Definition
Fear of gaining weight, denial of low body weight, absence of menstrual cycles,
Behaviors, OCD, dpression, aniety, rigidity, perfectionism, poor sexual judgement
Term
Bulimia Nervosa
Definition
Binge eating, purging food, excessive exercising, obsessed with their appearance, likely to be sexual active and maintain a normal weight.
Affects ADL, IADL, work, leisure skills, and social participation,
Medications, hospitalizations inpatient or outpatient, behavioral and cognitive therapies
OT: building of trust, know stages of recovery, socio-emotional needs, interest checklists, coping, education, etc.
Term
Oppositional defiant disorder
Definition
negativistic, hostile, defiant
Term
Conduct disorder
Definition
disregard for rights of others, aggression towards people and things
Term
Disruptive Behavior Disorders
Definition
Behavioral techniques used, medications - antipsychotics, antidepressants, anxiolytics, mood stabilizers.
OT: Other contributing disorders should be evaluated and assessed such as ADD, mood, and learning disorders, consider child's goals, stressors and family, skill development, behavioral approaches, parent, school education.
Term
Autism
Definition
organic brain pathology
more boys than girls
Symptoms at least six of the following:
Impaired social and cognitive function
impaired nonverbal behaviors
difficulty relating to others
lack of social seeking and social reciprocation
Difficulty w/ communication, lack of initiation, reflection, conversation is difficult, echolalia, lack of play
Repetitive behaviors, preoccupation, ritualistic routines, rigidity in behaviors, Stimming,etc.
Difficulty with sensory processing, delay prior to age of three, moods,
Term
Asperger's Disorder
Definition
genetic, metabolic, infectious, or perinatal causes
Normal IQ, high social skills, socially uncomfortable and demonstrate illogical thinking
Difficulty with social interaction, restricted interests, clumsiness, delay developmental motor milestones, has adequate language and engagement in activities.
Term
Rett's Syndrome
Definition
genetic metabolic disorder
deterioration of language, motor deterioration,
abnormal EEGs, seizures, regression occurs, muscle wasting, etc.
Term
Reactive Attachment Disorder
Definition
early experiences with pathogenic care care - disregard of child's physical and emotional needs, changes in caregivers - begins before the age 5
Inhibited type and disinhibited type
They are difficult to work with, lie, hoard, blame, etc.
Intervention: nondirective play therapy, sensory integrative therapy, attachment therapy, psychotherapy.
OT: Close and ongoing collaboration with child's family, build security, limit multiple caregivers, realistic and attainable goals.
Term
ADD
Definition
The presence of six or more symptoms that interfere for at least 6 months.
Symptoms: inattention, poor listening, organization, forgetfulness, figiting, excessive talking, impulsivity, answering questions before fully stated, difficulty with turn taking, interrupting , visual perceptual, language or cognitive probelms, evident before 7 years old, present in two settings
Difficulty to be soothed, defensive behavior, academic, perceptual motor tasks, memory, learning, self-esteem, etc.
medications used: stimulants, antidepressants, anxiolytics
OT: assess behavior, environment, modifications, training social skils and self management, sensory modulation techniques, consultation, family, etc.
Term
Intellectual disorders
Definition
Down Syndrom, Fragile X, etc. metabolic conditions, maternal substance abuse, trauma, prematurity, encephalitis, meningitis
IQ below 70
55-69 - mild - function I w/ ocas. support
40-54 - moderate - limited support and A.
25-39 - severe A required for most things
<25 - profound
OT - assess self-dermination, occupation performance skills, community and social participation, collaboration with team, andfamily.
Term
Mental Health Evaluation
Definition
Determine values, goals
Identify cog. percep. psychosocial strengths and limitation skills and impact on function
Determine functional problems ie: safety awareness
Treatment history and interest in recovery
Term
Mental health Intervention
Definition
Acute:
Manage behaviors, safety, stabilization, engagement in do-able activities, promote self efficacy, relaxation, stress management, self-determined goals, communication skills, d/c plan, life skills
Long Term Hospitalization
Develop & implement plan for self, occupational roles, graded activities in all areas, stress, relax. d/c plan w/ goals
Community Setting:
maintain existing skills, continued development of skills and support WRAP and NAMI, practical resources, community living skills, etc.
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