NURS 661 EXAM 1 KEY POINTS Questions with Complete Solutions

NURS 661 EXAM 1 KEY POINTS Questions with Complete Solutions Socratic Dialogue - Ans: Hallmark of CBT. Non-directive. A technique described as "mutual discovery in which the therapist guides the patient through a series of questions and answers to elicit automatic thoughts and assumptions, and examine the logic and evidence that relates to them" Diathesis-Stress Model - Ans: Serves to explore how biological or genetic traits diathesis interact with environmental influences, stressors to produce disorders such as depression, anxiety, or schizophrenia Hypothalamic-pituitary-adrenal (HPA) axis - Ans: Regulates cortisol, a potent hormone that inhibits growth, immune responses, and inflammatory responses. In severe and prolonged stress, this feedback to the pituitary gland is impaired and the hypothalamus does not decrease its activity, thus continuing to pump too much cortisol Cortisol - Ans: This potent stress hormone mobilizes energy stores, stimulates the release of glucose, potentiates the release of adrenaline, increases cardiovascular tone, and inhibits growth, immune, and inflammatory responses How PTSD affects cortisol production - Ans: For those with PTSD, it is hypothesized that the brain may become hypersensitive to the effects of cortisol. The person has a consequent loss of stimulus discrimination, and even minor triggers may cause the person to overact. Risk Factors for Eating Disorders - Ans: · Body image distortion · Dissatisfaction · Perfectionism · History of anxiety Erikson's Stages of Development Infancy (birth to 18 months) - Ans: Trust vs. mistrust Pathological Outcome: Psychosis, addictions, depression Erikson's Stages of Development Early childhood (18 months to 3 years) - Ans: Autonomy vs. self-doubt Pathological Outcome: Paranoia, obsessions, compulsions, impulsivity Erikson's Stages of Development Late childhood (3 to 6 years) - Ans: Initiative vs. guilt Pathological Outcome: Conversion disorder, phobias, psychosomatic disorder Erikson's Stages of Development School age (6 to 12 years) - Ans: Industry vs. inferiority Pathological Outcome: Inertia, creative inhibition Erikson's Stages of Development Adolescent (12 to 20 years) - Ans: Identity vs. role confusion Pathological Outcome: Delinquency, gender-related identity disorders, borderline psychotic episodes Erikson's Stages of Development Young adult (20 to 30 years) - Ans: Intimacy vs. isolation Pathological Outcome: Schizoid personality Erikson's Stages of Development Adulthood (30 to 60 years) - Ans: Generativity vs. stagnation Pathological Outcome: Midlife crisis, premature invalidism Erikson's Stages of Development Old age (65 year to death) - Ans: Ego integrity vs. despair Pathological Outcome: Extreme alienation, despair Freud's Psychosexual Stages Oral (birth to 18 months) - Ans: Task: to establish trust; comfortable expression and gratification of oral needs Problematic Traits: Excessive dependency; envy and jealousy; narcissism; pessimism; excessive optimism Freud's Psychosexual Stages Anal (18 months to 3 years) - Ans: Task: learning independence and control Problematic Traits: Orderliness; obstinacy; frugality; heightened ambivalence; messiness; defiance; rage; obsessive compulsive; sadomasochism Freud's Psychosexual Stages Phallic/Oedipal (3 to 6 years) - Ans: Task: identification with same sex parent; development of sexual identity Problematic Traits: sexual identity issues; castration in males; penis envy in females; excessive guilt Freud's Psychosexual Stages Latency (6 to 12 years) - Ans: Task: sexuality sublimated; emphasis on same sex peers Problematic Traits: inability to sublimate energies to learn; excessive inner control; obsessive traits Freud's Psychosexual Stages Genital (13 to 20 years) - Ans: Task: establishment of separation from parents and mature non-incestuous relationships with others Problematic Traits: reworking all the previous developmental issues; establishing a life not dependent on parents Hippocampus following a traumatic event - Ans: For those who have been significantly traumatized, it is much harder to process any new experience if there are not enough cells in the hippocampus Decreased functioning of the hippocampus is caused by increased levels of cortisol combined with other substances, such as glutamate, which damages dendrites in the hippocampus and eventually causes cell death. Glucocorticoids secreted during a traumatic experience shut down the hippocampus and make it impossible for memory to be adaptively linked. These hormonal changes result in behavioral disinhibition and an inability to learn from experience. Amygdala following a traumatic event - Ans: 2 types of reactions to traumatic events: 1) emotional under modulation with intrusive symptoms leading to hyperactivity of the medial prefrontal cortex and inhibition of the amygdala, 2) hypoarousal of the prefrontal cortex and activation of the amygdala When the amygdala is overactivated and irritable, kindling occurs. Kindling refers to lowering of the excitability threshold of neurons, rendering the person increasingly likely to develop certain symptoms. With repeated stress, kindling is thought to sensitize limbic neurons, so the reactions are set off by stimuli that were previously subthreshold Hypothalamus following a traumatic event - Ans: Regulates BP, body temperature, sleep, appetite, glucose levels, and the autonomic nervous system. During stress, a cascade of physiological responses occurs, with the limbic-hypothalamic system modulating and coordinating the biochemical activity of the autonomic, endocrine, and immune systems Thalamus following a traumatic event - Ans: Mediates the interaction between attention and arousal and is therefore relevant to the phenomenology of trauma. Can result in significant memory problems, and the person may be unable to integrate memories into the present and personal memory into identity. These memories are isolated from consciousness and thought to underlie the experiences of flashbacks, nightmares, avoidances, and dissociation Attunement - Ans: The capacity to read signals (often nonverbal) that indicate the need for engagement or disengagement Egocentrism - Ans: Having or regarding the self or the individual as the center of all things Piaget's Stages of Cognitive Development: 2-6/7-year-olds are this Someone's inability to understand that another person's view or opinion may be different than their own Minimizing - Ans: Cognitive distortion consisting of a tendency to present events to oneself or others as insignificant or unimportant Neuroplasticity - Ans: Refers to areas that are responsive to the environment and that can change. The lower brain structures such as the brainstem are more fixed than the higher brain functions of the cortex, which continue to develop throughout life. The cortex is the most "plastic" area of the brain Growth and reorganization Nurturing - Ans: Care for and encourage the growth or development of Overdeterminism - Ans: Refers to the idea that a problem most often has many different causes. The patient may not be able to provide a full description of these contributions and most likely is unaware of the multiple reasons for the current symptom. Ex: a young woman with bulimia may have factors that contributed to the development of her problem: sexual abuse, feelings of deprivation and neglect, recent loss, genetic predisposition, fear of weigh gain, cultural pressures, overemphasis on weight in her family, inability to self-soothe, hormonal imbalance, stress, friend who is bulimic, abusive/alcoholic father, depressed/unavailable mother, financial difficulties Reframing - Ans: A strategy that people can use, either on their own or in therapy, to help adjust their mindset. It often involves focusing on more positive thoughts, but it can also be centered on changing excessively high expectations to be more realistic A therapeutic technique that assists individuals in broadening restricted perspectives Resilience - Ans: The ability of an individual, family, or community to cope with adversity and trauma, and adapt to challenges through individual physical emotional, and spiritual attributes and access to cultural and social resources The Biomedical/Allopathic Model - Ans: Aim is to cure Symptoms are often thought to be the cause of the patient's problem and psychotropic medications are prescribed to target specific symptoms in an effort to eliminate or reduce symptoms Holistic model - Ans: Aim is to heal Symptoms are seen as a form of communication and are useful for understanding the meaning of the dysregulation and disharmony that are occurring for this person at a given time. By eliminating the symptoms with medication, we are essentially "shooting the messenger." Adaptive information processing (AIP) - Ans: Posits that most mental health problems and symptoms of psychiatric disorders are due to disturbance or dysregulation in the integration and connection of neural networks that occur in response to adverse life experiences. Normally information is taken in through the senses and connected adaptively to other memory networks so that storing and learning occur. There is thought to be innate self-healing in the brain and just as the body strives for homeostasis, so too does the brain through the regulation and processing of information. However, if something is experienced as overwhelming emotionally, brain processing is interrupted owing to the massive influx of hormones and neurotransmitters. It is as if our brain is saying: "Don't forget this, this is important!" These unprocessed experiences are considered to the basis of the symptoms of many mental health problems and psychiatric disorders. Acetylcholine (ACh) - Ans: Occurs in cholinergic tracts extending from the limbic structures to the cortex, and a decrease in concentration is associated with memory and cognitive impairments. Also regulates mood, mania, and sexual aggression. An increase is associated with depression Decrease is associated with memory, cognitive impairments, Parkinsonism Cortisol - Ans: Mobilizes energy stores, stimulates the release of glucose, potentiates the release of adrenaline, increase cardiovascular tone, and inhibits growth, immune, and inflammatory responses Dopamine - Ans: Produced in the substantia nigra and other areas in the brainstem; it is a key NT for motor action, integration of emotions and thoughts, and decision-making; it stimulates the HPA axis to release hormones; and acts as the reward system. Elevated levels may change mood, increase motor behavior, and disturb frontal lobe functioning, resulting in depression, memory impairment, and apathy. Parkinson's disease and depression have been linked with decreased levels of dopamine and an increase is linked with schizophrenia and mania Gamma-aminobutyric acid (GABA) - Ans: This inhibitory NT is found in most neurons in the CNS. It is involved in postsynaptic inhibition when benzodiazepines are given for anxiety, which further decreases the firing of the neurons. It plays a role in inhibition; reduces aggression, excitation, and anxiety; has anticonvulsant and muscle relaxing properties; impairs cognition and psychomotor functioning. A decrease is associated with anxiety disorders, schizophrenia, and mania Glutamate - Ans: Is found in all cells, and its major receptor, N-methyl-d-aspartate (NMDA), helps to regulate brain development. Too much is toxic to neurons Acting out (immature) - Ans: Avoiding conscious experience of the emotion through impulsive action (e.g., instead of feeling sad, a person gets drunk) Denial (immature) - Ans: Avoiding the reality of painful reality by ignoring or refusing to acknowledge reality (e.g., a man with schizophrenia denies that he is ill and does not take his medication) Involves blocking external events from awareness. If some situation is just too much to handle, the person just refuses to experience it. Ex: Smokers may refuse to admit to themselves that smoking is bad for their health Hypochondria (immature) - Ans: Exaggerating an illness arising from unacceptable feelings (e.g., anger and hostility are transformed into pain and somatic complaints) Somatization (immature) - Ans: Converting emotion into bodily symptoms (e.g., instead of getting angry, the person gets a headache) Projection (immature) - Ans: Perceiving and reacting to unacceptable feelings and impulses as if they were outside the self (e.g., instead of the person feeling anger, anger is experienced as coming from others toward the person who is doing this, as during paranoid delusions) To disown certain unacceptable aspects of self by ascribing them to other people or the environment. Ex: blaming others for problems within the self or believing others do not like you when you actually have strong negative feelings toward them Introjection (immature) - Ans: Internalizing the qualities of the other (e.g., identification with the aggressor through which the person becomes aggressive to gain control) To uncritically accept others' beliefs and standard without discriminating and assimilating what belongs to self and eliminating what does not. Ex: "be a good girl," "don't be angry," and "boys don't cry" Splitting (immature) - Ans: Inability to integrate positive with negative aspects of oneself and then projecting this onto other people or situations (e.g., a woman tells her husband she loves him one day and hates him the next day, even though nothing has changed to warrant this) Regression (immature) - Ans: Avoiding emotional pain through returning to an earlier level of development (e.g., a child begins wetting the bed after a sibling is born) A movement back in psychological time when one is faced with stress Ex: a child may begin to suck their thumb again or wet the bed when they need to spend time in the hospital Displacement (Neurotic) - Ans: Shift of emotion from a person or object to one that is less distressing (e.g., instead of expressing anger at his boss, the man kicks his dog) Dissociation (Neurotic) - Ans: Avoiding emotional distress through an altered state of consciousness, such as fugue states or conversion reactions (e.g., a person loses several hours of time and does not remember what happened) Intellectualization (Neurotic) - Ans: Using intelligence to avoid intimacy and expression of disturbing feelings (e.g., a woman explains in great detail all the pluses of the new city where she is moving to assuage her anxiety about leaving a significant relationship) Rationalization (Neurotic) - Ans: Offering explanations in an attempt to explain behaviors or feelings that are unacceptable (e.g., after doing poorly on a test, the student believes the test or teacher is stupid) Reaction formation (Neurotic) - Ans: Transforming an unacceptable impulse into the opposite (e.g., a woman unexpectedly runs into someone she does not like on the street and is overly friendly) Repression (Neurotic) - Ans: Thought to be the basis of all other defenses and involves withholding from consciousness an idea or feeling that is unacceptable (e.g., the child cannot remember her anger or hitting her mother) Unconscious mechanism employed by the ego to keep disturbing or threatening thoughts from becoming conscious Ex: during the Oedipus complex, aggressive thoughts about the same gender parent are repressed Sublimation (Mature) - Ans: Channeling unacceptable impulses through pursuing socially acceptable goals (e.g., a young man who is aggressive and impulsive pursues a career as a boxing coach) Suppression (Mature) - Ans: Consciously deciding to forget an unpleasant feeling (e.g., a woman is preoccupied with the illness of her father and decides to not worry about it because there is nothing she can do about it) Altruism (Mature) - Ans: Using service to others and vicariously experiencing pleasure through doing good for others to avoid negative feelings about oneself (e.g., a young woman is a social activist) Humor (Mature) - Ans: Using comedy to express feelings and thoughts without discomfort (e.g., a person uses self-deprecating humor to put others at ease) Isolation - Ans: The condition of being separated, such as in social isolation In psychoanalytic theory, a defense mechanism that relies on keeping unwelcomed thoughts and feelings from forming associative links with other thoughts and feelings, with the result that the unwelcome thought is rarely activated Closed-ended question - Ans: Elicit the specific details - such as symptom type, severity, frequency, duration, and the context in which a symptom occurs - that are necessary to thoroughly assess a content region or establish a diagnosis Ex: "How many drinks did you have?" "How often do you feel that way?" Empathetic statement - Ans: Ex: "You must have been so hurt by that." "That is very frustrating." "It is hard to lose someone you love." Gentle command - Ans: Ex: "tell me about your family situation," "try to describe how you felt when...," "share with me what you think a good outcome would be." Open-ended question - Ans: Invite exploration in new content regions, reveal what is uppermost in the patient's mind, and may yield important information about the patient's capacities, defenses, or degree of resistance to engaging in psychotherapy Ex: "what brings you in today?" "How can I help you?" "How would you describe your relationship with ...?" Qualitative question - Ans: Ex: "How have you been sleeping?" "How is school going?" "How have you been getting along with your mom?" Swing question - Ans: Client can say "no" or client can elaborate Ex: "Can you describe the depressive symptoms?" "Can you tell me anything more about that?" "Can you tell me what you're thinking right now?" Domineering - Ans: I try to change other people too much Intrusive - Ans: It is hard for me to stay out of other people's business Overly nurturing - Ans: I put other people's needs before my own too much Vindictive - Ans: I fight with other people too much Classical Psychodynamic Therapist role - Ans: Objective Classical Psychodynamic Perspective - Ans: One-person psychology Classical Psychodynamic Motivation - Ans: Drives; sex and/or aggression Classical Psychodynamic Focus of exploration - Ans: Then and there; genetic roots of the problem (how a person's transference reaction is linked to feelings belonging to a person from the past) Classical Psychodynamic Aim - Ans: Make the unconscious conscious Classical Psychodynamic Change agent - Ans: Insight Classical Psychodynamic Symptom - Ans: Psychopathology Classical Psychodynamic Transference - Ans: Interprets in light of the past Classical Psychodynamic Countertransference - Ans: Caused by the patient; less disclosure by therapist Classical Psychodynamic Resistance - Ans: Intrapsychic event that involves a defense working against change Classical Psychodynamic Interpretation - Ans: Of wish/defense conflicts Relational Psychodynamic Therapist role - Ans: Participant-observer Relational Psychodynamic Perspective - Ans: Two-person psychology Relational Psychodynamic Motivation - Ans: Emotional communication and affect regulation Relational Psychodynamic Focus of exploration - Ans: Here and now; both patient and therapist contributions to the interactions; and patient's experience Relational Psychodynamic Aim - Ans: Resolve rupture in the therapeutic alliance Relational Psychodynamic Change agent - Ans: Mindfulness Relational Psychodynamic Symptom - Ans: A communication Relational Psychodynamic Transference - Ans: Cautious about generalizing to past Relational Psychodynamic Countertransference - Ans: Co-constructed; use of countertransference Relational Psychodynamic Resistance - Ans: Co-constructed unconscious rupture of the therapeutic alliance; interpersonal ruptures outside therapy Relational Psychodynamic Interpretation - Ans: Of alliance ruptures outside as well as inside therapy Supportive Therapy - Ans: Aimed toward stabilization through restoring function, reducing anxiety, strengthening defenses, and facilitating more effective problem-solving Psychoanalytic Therapy - Ans: Aimed toward processing through interpreting unconscious conflict and gaining insight. The transference interpretations increase, as does the number of sessions per week. By increasing the number of sessions per week, it is thought that the transference intensifies, which is desired When to Refer to Expressive Psychotherapy - Ans: Art, music, dance - patient to explore different emotions When to Refer to Group Therapy - Ans: Deal with social skills, anger, loneliness, shy, depression When to Refer to Psychoanalytic Therapy - Ans: The unconscious supports the patient's status If the person wants to understand himself or herself deeply and significantly change When to Refer to Supportive Therapy - Ans: Increasing self-esteem and dealing with life stressors Often most useful for people who need clarification and help in sorting out issues that they would be able to sort out under other circumstances Focuses on safety, education, and assisting with enhancing coping skills Restore emotional equilibrium as quickly as possible When to Refer to Trauma-Focused Cognitive Behavioral Therapy - Ans: Processing and coping with negative effects of trauma Mindfulness - Ans: A state of open, nonjudgmental awareness of current experience Internal and having external awareness in abundance while dissociation is the deficiency of internal and external awareness. Projective Identification - Ans: A specific type of countertransference that deepens the therapist's understanding of the patient It essentially involves a patient behaving in such a way that subtle, interpersonal pressure is placed on the therapist to take on dimensions of the patient's experience or unconsciously identify with facets of him- or herself This out-of-the-blue feeling may reflect the patient's own fear being projected onto the therapist, which the therapist experiences in place of the patient. Not only fear can be projected, but also anger, boredom, intrusiveness, passivity, and other feelings. Transference - Ans: The patient's thoughts, feelings, and behaviors that are associated with early important relationships with caretakers and significant others and that are felt toward the therapist EMDR procedures - Ans: Activates both sides of the brain. Involves the past, present, and future. The therapist guides the patient in processing affective, cognitive, and somatic material with procedures and protocols that include some form of bilateral stimulation (BLS) during a session. The BLS may take form of eyes moving horizontally back and forth, sounds alternating in each ear, or alternate tapping on each hand or knee. The goal is to bring the trauma to an adaptive resolution. Research indicates that trauma involves right-brain processing and most psychotherapy is a left-brain endeavor, so there may be areas that talk therapy does not reach. Processing in EMDR therapy seems to rapidly connect left-brain ways of processing information with emotional right-brain information. 4 signs that EMDR is helping - Ans: 1. emotional regulation 2. positive self-relief 3. better sleep 4. improving self-esteem EMDR S/E - Ans: Vivid dreams Nightmares Emotionally stressful 8-Phase Protocol for EMDR - Ans: 1. Patient History and Treatment Planning 2. Preparation 3. Assessment 4. Desensitization 5. Installation 6. Body scan 7. Closure 8. Reevaluation Theoretical framework behind motivational interviewing (MI) - Ans: TRANSTHEORETICAL MODEL This is an evidence-based person-centered approach that started in addiction counseling coupled with the transtheoretical model of change: precontemplation, contemplation, preparation, action, and maintenance MI Phases of the Change Process - Ans: Engagement Focusing Evoking Planning MI Engagement - Ans: The phase in which a trusting and respectful relationship is established Goal: establish trust and helping relationship MI Focusing - Ans: The process of clarifying the patient's goals and direction Goal: Identify direction/target of change MI Evoking - Ans: Eliciting motivation for specific change Goal: Bring forth person's motivation for change Listen for change talk and amplify it with reflective statements in order to develop discrepancy between sustaining and changing behavior MI Planning - Ans: The final stage, planning a specific change strategy Goal: Elicit a plan that will be followed Open Questions - Ans: Questions that cannot be answered yes or no or with short answers Affirming - Ans: Comments on the person's strengths and efforts Reflecting - Ans: Statements mirroring the content or feelings explicitly or implicitly stated by the person Summarizing - Ans: Link together what has been stated or serve in moving from one idea to the next idea Simple Reflections - Ans: Staying with what was said Complex Reflection - Ans: Adding to the content, feeling, or highlighting discrepancies in behaviors or beliefs Steps of Cognitive Restructuring - Ans: 1. Tune in ... keep a thought diary. Identify the upsetting situation. Describe the event or problem that's upsetting you 2. Focus on the feeling words that are negative and record them. Give each negative feeling word a score on a scale from 1 (for the least) to 100 (for the most) 3. Substitute rational responses in the right-hand column on the automatic thought record and record how strongly you believe each one between 0 (not at all) and 100 (completely) 4. Review the list of rational responses and observe your feelings. Re-rate the scores to see how you have modified negative feelings to more positive feelings Guided Relaxation - Ans: Behavioral technique aimed at reduction of autonomic nervous system responses to anxiety Deep breathing exercises, muscle relaxation Meditation - Ans: Behavioral technique aimed at reduction of autonomic nervous system responses to anxiety Support stress reduction, control emotions, and sense of well-being Motivational Interviewing (MI) - Ans: Facilitates the patient's inherent motivation to change. It is not a therapy but a method of communication that partners with patients through accepting their autonomy and respecting that they have within themselves the knowledge of how to change Shame Attacking Exercises - Ans: In this type of therapy, the therapist engages the individual in exercises that emphasize their concern for what others think of them. For example: a person who is afraid of drinking soup in public may be assigned the task of going to a restaurant with a friend, ordering soup, and drinking it loudly while the fried makes note of how many people are really interested in what they are doing. The friend would then share the notes on the actual responses of the other diners as a way to disarm the person's irrational belief that others are looking at him or her eat, slurp, etc. Social Skills Training - Ans: Review and instruct on behaviors that will improve the potential for successful social interactions. For example, a therapist may notice that the patient looks at the floor or the ceiling during conversation or when introducing herself. The APPN may make use of this information by role-playing skills such as maintaining eye contact during an interview, shaking hands assertively, developing techniques for self-expression, and conveying opinions as well as overt changes such as appropriate language in public. Avoidant Personality Disorder - Ans: CBT is the best therapy for this PD Cluster C ("Anxious") Self-statement: "I'm really afraid of what people will think of me, so I avoid making new friends to prevent rejection." Behavioral clues: the patient may appear shy and nervous with a poignant eagerness to make contact. He may begin the interview reluctant to open up and will typically become quite self-revealing once rapport has been established Avoidant PD Mnemonic - Ans: Mnemonic: CRINGES (4 of these 7) Certainty of being liked required before willing to risk involvement Rejection possibility preoccupies his thoughts Intimate relationships avoided New relationships avoided Gets around occupational activities that involve interpersonal contact Embarrassment potential prevents new activities Borderline Personality Disorder - Ans: DBT is the best therapy for this PD Cluster B ("Dramatic") Self-statement: "I need people desperately, and when people reject me, I fall apart completely. I hate them, and I get suicidal." Behavioral clues: may alternately idealize and devalue you over the course of the interview; may be unusually emotionally liable Borderline Personality Disorder Mnemonic - Ans: Mnemonic: I DESPAIRR Identity disturbance Disordered, unstable affect owing to a marked reactivity of mood chronic feelings of Emptiness recurrent Suicidal behavior, gestures, or threats, or self-mutilating behavior transient, stress-related Paranoid ideation or severe dissociative symptoms frantic efforts to avoid real or imagined Abandonment Impulsivity in at least two areas that is potentially self-damaging inappropriate, intense Rage or difficulty controlling anger a pattern of unstable and intense interpersonal Relationships characterized by alternating extremes of idealization and devaluation Dependent Personality Disorder - Ans: Psychotherapy/CBT is the best therapy for this PD Cluster C ("Anxious") Self-statement: "I'm pretty passive and dependent on others for direction, and I go far out of my way not to displease people who are important to me." Behavioral clues: The patient will seem to make extraordinary attempts to immediately gain your affection Dependent Personality Disorder Mnemonic - Ans: Mnemonic: RELIANCE (5 of these 8) Reassurance required for decisions Expressing disagreement difficult (because of fear of loss of support or approval) Life responsibilities assumed by others Initiating projects difficult Alone (feels helpless and a sense of discomfort when alone) Nurturance (goes to excessive lengths to obtain nurturance and support) Companionship sought urgently when close relationship ends Exaggerated fears of being left to care for self Obsessive-Compulsive Personality Disorder - Ans: CBT is the best therapy for this PD Cluster C ("Anxious") Self-statement: "I'm a perfectionist. I keep lists, I drive myself hard, and I'm very serious about life." Behavioral clues: the patient is meticulously groomed and dressed. He will tend to give an excessively detailed and accurate account of his symptoms. Obsessive-Compulsive Personality Disorder Mnemonic - Ans: Mnemonic: LAW FIRMS (4 of these 8) Loses point of activity Ability to complete tasks compromised by perfectionism Worthless objects (unable to discard) Friendships (and leisure activities) excluded (owing to preoccupation with work) Inflexible, scrupulous, overconscientious Reluctant to delegate Miserly Stubborn Main concepts of interpersonal therapy - Ans: Patients who need help with relationships with others A brief, structured psychotherapeutic approach based on the operating principle that psychiatric disorders occur within an interpersonal, social context. Symptoms of psychiatric disorders in four specific areas of social functioning create problems which IPT therapists are trained to intervene: 1) interpersonal disputes, role transitions, grief, and interpersonal deficits. CAGE Questionnaire - Ans: CAGE questionnaire is the best quick screen for alcoholism, in which a positive response to two or more of the items implies a 95% chance of alcohol abuse or dependence. Cut down: "Have you felt you should cut down on your drinking?" Annoyed: Have people annoyed you by getting on your case about your drinking?" Guilty: "Have you ever felt bad or guilty about your drinking?" Eye-opener: "Have you ever needed to take a drink first thing in the morning to steady your nerves or get rid of a hangover?" What differences interpersonal therapy has for adolescents - Ans: Shortening the traditional 16-week IPT protocol used with adults to a 12-session model for this population Another modification in the protocol was the addition of parents in the adolescents' treatment