PMHNP Boards Summary 2024, Updated.
Sleep circuit
ventrolateral preoptic nucleus (VLPN) in hypothalamus inhibits the brainstem arousal nuclei
Sleep stages
Stage 1-4 are progressively deeper stages of non-REM sleep
REM stage comes in cycles, 1st REM happens 80-100 min into sleep.
REM cycles ...
PMHNP Boards Summary 2024, Updated.
Sleep circuit
ventrolateral preoptic nucleus (VLPN) in hypothalamus inhibits the brainstem arousal
nuclei
Sleep stages
Stage 1-4 are progressively deeper stages of non-REM sleep
REM stage comes in cycles, 1st REM happens 80-100 min into sleep.
REM cycles lengthen throughout sleep
-stage 4 NREM decreases as we age more for men than women.
-Less REM associated with organic brain dysfunctions.
SLAP
Suicide assessment:
-Specific plan
-Leathality of suicide method
-Accessibility of means
-Proximity of helping resources
IS PATH WARM - suicide
I-suicidal ideation
S- substance abuse
P-purposelessness
A-Anger
T-Trapped
H-Hopeless
W-withdrawl from social interactions
A-Anxiety
R-Recklessness
M-Mood change
DIGFAST
Mania Assessment
D = Distractibility and easy frustration
I = Irresponsibility and erratic uninhibited behavior
G = Grandiosity
F = Flight of ideas
A = Activity increased with weight loss and increased libido
S = Sleep is decreased
T = Talkativeness
SIGECAPS
S-sleep disoreder
I-interest deficit (anhedonia)
G-guilt (worthlessness, hopeless, regret)
E-engery
C-contration deficit
A-appetite disorder
,P-psychomotor retardation
S-suicidality
DEPRESSION
MSE areas
"All Bad Subjects are Tough Troubled Characters"
A-Appearance
B-Behavior
S-Speech
A-Affect
T-thought process
T-Thought content
C-cognition
SLUMS
11 item congitive assessment: tests, short-term memory, calculations, naming, clock,
geometery
Yalom
Group Therapy -Principle of universality: you are not alone in your probems.
Mauhler
Theory of object relations
0-2 mo. normal autism - no recognition of others
3-5 mo. symbiosis - primary caretaker extension of self
5-36 mo. separation from caretaker (4 substages)
-differentiation 5-8 aware of others
-Practicing 8-16 mobility starts explores
-Reapproachent 16-25 aware of big world, emotional support from caretaker feuls
learning
-Object constancy 25-36 memory of caretaker assures child, love self by internalizing
love of caretaker
Albert Ellis
Rational Emotive Therapy (RET)
People's beliefs strongly affect their emotional functioning.
Core Irrational Beliefs:
Demandingness or Absolutism
Demand for Love and Approval
Demand for Success or Achievement
Demand for Comfort
Certain irrational beliefs make people feel depressed, anxious or angry and lead to self-
defeating behaviors.
It is important to use vigor or energy when disputing irrational beliefs.
Disputing is not just a rational or cognitive method but also an emotional method of
changing irrational beliefs into rational ones.
Carl Rodgers
Person Centered Therapy
Unconditional Positive Regard
"Humanistic" psychology
Erickson Stages (8)
, 1. Trust vs Mistrust ; 0-1
2. autonomy vs shame & doubt: 2-3
3. initiative vs guilt; 4-6
4. Industry vs. inferiority; 7-12
5. Identity vs role confusion; 13-19
6. Intimacy vs Isolation; 20-34
7. generativity vs stagnation; 35-65
8. Integrity vs. despair; 65-death
Trust vs Mistrust
0-18mo - develope trust in cartaker
fail: difficulty receiving and giving
Autonomy vs shame & doubt
18mo-3 - gain some self-control and will power, body control
fail: lack of self-confidence and rage against one's self
Initiative vs guilt
3-6 - indentify and direct one's activities
Fail: feeling of inadequacy and guilt
Industry vs. inferiority
6-12 - self-confidence and peer recognition
Fail: low self-esteem and poor interpersonal relations
Identity vs role confusion
12-20 - develpement of secure self indentity
FAil: lack of direction and confidence in self
Intimacy vs Isolation
20- can i love?
Generativity vs stagnation
35-65 - can i make my life count?
Integrity vs. despair
65-death - did my life matter?
SUSPECT
paranoid PD
Spousal infidelity suspected
Unforgiving (bears grudges)
Suspicious
Perceives attacks (and reacts quickly)
Enemy or friend? (suspects associates and friends)
Confiding in others is feared
Threats perceived in benign events
DISTANT
Schizoid PD - 7.5%
Detached or flattened affect
Indifferent to criticism or praise
Sexual experiences of little interest
Tasks done solitarily
Absence of close friends
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