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Exam (elaborations) NUR 255 Mental Health Exam 1(NUR255) (NUR255)
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Exam (elaborations) NUR 255 Mental Health Exam 1(NUR255) (NUR255)
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Mental Health Exam 1Mental health- able to recognize own potential, cope with normal stress, work productively, make a
contribution to the community
Traits of mental health- think rationally, communicate appropriately, learn, grow emotionally, be
resilient, have a healthy self-esteem
Mental illness- disorders with definable diagnosis.
Significant dysfunction in mental functioning r/t developmental, biological, and physiological
disturbances
Culturally defined
Resilience- ability and capacity to secure resources needed to support well-being (essential to recovery)
Characterized by: optimism, sense of mastery, competence
Diathesis- biological predisposition (runs in families)
Stress- environmental stress or trauma
Combination of genetic vulnerability and negative environmental stressors
DSM5- The Diagnostic and Statistical Manual of Mental Health Disorders, 5 th edition (official medical
guidelines of the American Psychiatric Association for diagnosing psychiatric disorders)
Psychiatric Mental Health Nurses- employ purposeful use of self, use nursing, psychosocial,
neurobiological theories and research, work with people throughout the lifespan, employed in a variety
of settings
NANDA- North American Nursing Diagnosis Association International
NANDA-I describes a nursing diagnosis as a clinical judgement about individual, family, or community
responses to actual or potential health problems and life processes
Future challenges and roles- aging population (Alzheimer’s & dementia), increasing cultural diversity
(cultural competence), expanding technology, patient advocacy, legislative involvement
Psychoanalytic Theories-
Freud’s Psychoanalytic Theory- revolutionized the way we think about mental health. Freud’s theory
offers a comprehensive explanation of complex human processes and suggests that the formation of a
patient’s personality is strongly influenced by childhood experiences.
Personality structure-
Id- pleasure principle, reflex action, primary process (babies, go- green light)
, Ego- problem solver, reality tester (older, caution- yellow light)
Superego- moral competence (angel on shoulder, red light)
Defense mechanisms and anxiety- operate on unconscious level. Deny, falsify, or distort reality to make it
less threatening) Useful to a point
Experiences during the early stages of life determine and individual’s lifetime adjustment patterns and
personality traits. (first 5 years)
Freudian Theory and Nursing- Formation of personality, conscious and unconscious influences,
importance of individual talk sessions, attentive listening, transference, and counter transference.
Transference- Pt treats you like someone in their life
Countertransference- Staff treats pt. like someone in their life
Erikson’s Ego Theory- Eight stages of development (Personality continues to develop through old age).
Erik Erikson was an American psychoanalyst who was a follower of Freud. Erikson however, believed
that Freudian theory was restrictive and negative in its approach. He also stressed that an individual’s
development is influenced by more than the limited mother-child-father triangle and that culture and
society exert significant influence on personality.
Stage Age Stage Age
Trust vs. mistrust 0- Identity vs. role confusion 12-
1.5 20
Autonomy vs. shame- 1.5- Intimacy vs. isolation 20-
doubt 3 35
Initiative vs. guilt 3-6 Generativity vs. self- 35-
absorption 65
Industry vs. inferiority 6- Integrity vs. despair 65+
12
Erikson’s theory and nursing- developmental model is an important part of nursing assessment. It helps
determine what type of interventions are most likely to be effective
Hildegard Peplau’s Theory of Interpersonal Relationships in Nursing-
The art of nursing- provide care, compassion, and advocacy. Enhance comfort and well-being.
Her theory is mainly concerned with the process by which the nurse helps patients make positive
changes in their health care status and well-being.
The science of nursing- Application of knowledge to understand a broad range of human
problems and psychosocial phenomena, intervene in relieving patients’ suffering and promote
growth.
, Peplau and the therapeutic relationship- Levels of anxiety, interventions to lower anxiety, aim to
improve patient’s ability to think and function
Behavior Theories-
Pavlov: (Classical conditioning theory.) Pavlov was a Russian physiologist who on a Nobel Prize
for his outstanding contributions to the physiology of digestion which he studied through his
well-known experiments with dogs. Pavlov formalized his observations of behaviors in dogs in a
theory of classical conditioning (bringing about involuntary behavior or reflexes through
conditioned response to stimuli).
Watson: (Behaviorism Theory) An American psychologist who rejected the unconscious
motivation of psychoanalysis as being too subjective. He developed a school of thought referred
to as behaviorism which he believed was more objective or measurable. Watson contended that
adaptive and maladaptive personality traits and responses were socially learned through
classical conditioning.
B.F. Skinner (Operant Conditioning Theory) Skinner represented the second wave of behavioral
therapists. Skinner researched operant conditioning in which voluntary behaviors are learned
through consequences, and behavioral responses are elicited through reinforcement which
causes a behavior to occur more frequently. A consequence can be a positive reinforcement or a
negative reinforcement. Absence of reinforcement or extinction also decreases behavior by
withholding a reward that has become habitual.
Behavior therapy-
Behavior therapy is based on the assumption that changes in maladaptive behavior can occur
without insight into the underlying cause. This approach works best when it is directed at
specific problems and the goals are well defined. Behavior therapy is effective in treating people
with phobias, alcoholism, schizophrenia, and many other conditions.
Modeling: In modeling, the therapist provides a role model for specific identified behaviors, and
the patient learns through imitation. This may be done with the therapist doing the modeling,
another patient modeling the behavior or the presentation of a video for the purpose.
Operant conditioning: The basis for behavior modification and uses positive reinforcement to
increase desired behaviors. For example, when desired goals are achieved or behaviors
performed, patients might be rewarded with tokens. Operant conditioning has been useful in
improving the verbal behaviors of mute, autistic, and developmentally disabled children.
Systematic Desensitization: A form of behavior modification therapy that involves the
development of behavior tasks customized to the patient’s specific fears; these tasks are
presented to the patient while using learned relaxation techniques.
Aversion therapy: This technique is used widely to treat behaviors such as alcoholism, sexual
deviation, shoplifting, hallucinations, violent and aggressive behavior, and self-mutilation.
Aversion therapy is sometimes the treatment of choice when other less drastic measures have
failed to produce the desired effect.
1. Pairing of a maladaptive behavior with a noxious stimulus so that anxiety or fear
becomes associated with the once-pleasurable stimulus.
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