N421: Exam 2 questions with correct answers
Mental health Correct Answer-Linear Model
On a continuum (btwn MH and mental illness)
We can move up and down this model (kids even quicker)
Attachment theory Correct Answer-LT dynamics btwn infants and
caregivers, established idea of "secure base"
Describes 4 attachment styles based on bx and using standardized
assessment tool
Strange situation classification
3 types:
1. secure- distress when separated from mom, friendly to stranger with
mom
2. ambivalent- intense distress when separated from mom and fear of
stranger
3. avoidant- no interest when separated from mom, play well with
stranger
4. disorganized- inconsistent bx
Development of attachment- is attachment figure sufficiently near,
attentive and responsive? yes/no
Strange situation classification Correct Answer-Measures security of
attachment in 1-2YO
20min of observation
8 stages of 3 min:: baby + mom + research at start with toys
,Score baby on proximity and contact-seeking, contact maintaining,
avoidance of proximity and resistance to contact
Depression in kids Correct Answer-Equal rates until puberty: girls x2
more likely
Fam hx (20-50%): genetic, environmental factors
2/3 don't receive proper tx
s/s- irritability, sad, sleep disturbance, suicidal thoughts
-don't share crying and depressive thoughts
-somatic sx (HA, ab pain)
-no wt gain, deteriorating school performance
Adolescent depression Correct Answer-2:1 ratio FM to M
High suicide risk: 3rd leading cause
HIgh risk if comorbidities present: pregnancy, uncertain sex orientation
-poor peer/social relations, academic performance
-events: physical illness, death, abuse, loss
s/s- difficulty expressing emotional distress (act out/cutting to relieve
pain)
-violent: "get away" bx
-moodiness, anger, withdrawal, frustration, loss of interest, restlessness
Primary int Correct Answer-Safety first
Infant attachment
,Socialization, self-esteem building
Temperament: neg mood
Development of prgms, health teaching (schools and parents)
2ndary int Correct Answer-Depression assessment in kids
Screening- tools, measures, early ID of individuals, those at risk, early tx
-PHQ9 (pt HC q), BDI, GDS
-sit down to be eye-level with pt
Ask someone if they feel like harming themselves doesn't precipitate
suicide attempt
tertiary int Correct Answer-Meds:
SSRIs- prozac, paxil, celexa, zoloft, etc
-selective 5HT receptor inhibitors: more 5HT available
-significant sex SEs: assess
Mixed/SNRIs- wellbutrin, trazodone, effexor, cymbalta, remeron
-black box warning on SSRIs for adolescents regarding suicidality (may
give them E to carry out suicidal thoughts)
-5HT NE reuptake inhibitors: leaves 2 NTs at higher level
2-4wks to reach peak level
-low E and dark thoughts at start of tx -> increase E level
Other modalities
-CBT, psychotx, group/peer counseling
-substance use assessment
, -fam therapy
-harm reduction/substance use cessation
-exercise
Attention-deficit hyperactivity and attention-deficit Correct Answer-
ADHD- difficulty focusing and maintaining attention and hyperactivity
and impulsivity
3 types- combined, inattentive, hyperactive-impulsive
Genetic predisposition and chaotic environment
Early onset- poor ID
Int- meds, bx tx (incentives), home and school environments
Inattention dx Correct Answer-6/+ s/s for at least 6m to degree that's
maladaptive and inconsistent with developmental level
Often fails to:
Give close attention to detail/makes careless mistakes
Sustaining attention in tasks
Listen when spoken to directly
Follow thru on instructions and finish school work, chores (not d/t
oppositional bx)
Organizing tasks and activities
Engage in tasks requiring sustained mental effort
Often loses things needed for tasks
Distracted by extraneous stimuli
