Download OT5012 Exam 2 Study Guide and more Exams Advanced Education in PDF only on Docsity!
OT5012 Exam 2 Study Guide
Brain Abnormalities of MDD - Answer - functional abnormalities found in the limbic system (represents centers of emotions); also changes in hippocampus -- results in blunted or decreased behavioral and physiological reactivity to sad or negative stimuli
- brain abnormalities may not be the cause of the mood disorder, but may develop because of the disorder
- MDD patients who committed suicide were found to have abnormal connections among left anterior limb of the internal capsule, left middle frontal cortex, orbital prefrontal cortex, and left thalamus
Mania versus Hypomania - Answer - manic: euphoria, irritability, grandiosity, decreased sleep impulsivity, and distractibility (interferes with daily functioning); highly elevated or irritable mood lasting at least 1 week, with or without psychotic symptoms such as delusions and hallucinations
- hypomania: similar but less intense mood and energy elevation than mania
BPD Manic versus Depressive Symptoms - Answer - manic: grandiosity, persistent elevated mood, minimal need for sleep, excessively talkative or having pressured speech, racing thoughts or flights of ideas, distractibility, excessive goal-directed activity or psychomotor agitation, impulsivity or participation in dangerous or risky activities, purchasing sprees, hyper sexuality, short-temper
- depressive: feeling hopeless and helpless, decrease in personal hygiene, statements regarding not wanting to live, strong remorse, depression, past suicide attempts, risky behaviors, social withdrawal, fatalistic attitude about the future, believing that their current situation and emotional state will never change, suicidal notes, saying farewell to family members, creating a plan for suicide
Alternative Treatments for MDD - Answer - pharmacology: antidepressants that regulate neurotransmitters particularly serotonin and norepinephrine (SSRIs and SNRIs), tricyclics and MAOIs (lithium for BDD)
- ECT: controlled seizure; for those who are resistant to pharmacology
- repetitive transcranial magnetic stimulation (rTMS): for treatment resistant depression; noninvasive magnet field and has fewer cognitive and memory side effects than ECT
Course of Action for Suicidal Ideation - Answer it is important for OTs to be aware of signs and symptoms of suicidal ideation so they can identify them in their clients and make timely referralsterm-
Positive Symptoms - Answer - delusions: fixed false beliefs; don't change even when the
individual is presented with new information or evidence against the belief
- hallucinations: perceptual disturbances that occur without external stimulus such as hearing or seeing things that are not there; experience auditory, smell, visual and/or tactile delusion
- disorganized speech: incoherent or irrelevant speech, infers disorganized thinking; tangential thoughts, loose associations, incoherence (word salad)
- disorganized or abnormal motor behavior: catatonia psychomotor disturbances including lack of psychomotor activity or response to the environment
Schizophrenia and Genetics - Answer - strong genetic component; risk for immediate family members is 10% and 50% in twin studies
- appears to be linked to over 100 genetic variants associated with schizophrenia, but these gene variants are not singularly predictive of the manifestation of the illness
- genetic and environmental risk factors appear to work additively in conjunction with each other to increase risk
- causes include excess of dopamine, γ-amino-butyric acid (GABA) and glutamate, brain structures abnormalities, prenatal exposure to environmental insults including maternal infections, nutritional deficiencies, and drug toxicity as well as birth complications, exposure to early stressful life events or trauma, and use of cannabis
Delusional Disorder - Answer - 1 or more delusional belief for > 1 month
- other positive and negative psychotic symptoms not present
- limited impairment in ADLs
Brief Psychotic Disorder - Answer - sudden onset of positive psychotic symptoms lasting between 1 day and 1 month
- daily functioning possibly impaired
- safety concerns present
Schizoaffective Disorder - Answer - presence of major mood episode (major depressive, manic, or mixed episode)
- delusions and hallucinations must be present for at least 2 weeks in absence of mood disorder
- psychotic symptoms present during major mood episode
- occupational functioning impaired (not necessary for diagnosis)
Negative Symptoms - Answer - avolition, alogia, anhedonia, asociality
Panic Disorder - Answer - 4 panic attacks within 4 weeks or 1 attack within last month
- attack followed by at least 1 month or more of (fear of future panic attacks, losing control, experiencing heart attack, feeling of going crazy)
- maladaptive change in behavior
Specific Phobia - Answer - irrational fears (marked and persistent, object or situation, avoidance, must last for > 6 months)
- exposure to object or situation = intense fear and/or anxiety
- 5 types: situational, natural environment, blood-injection injury, animal, other (loud sounds, falling, choking, costume character)
Social Anxiety Disorder - Answer - avoidance and fear of social environment or situations that may elicit criticism
- social interactions such as meeting unfamiliar individuals, engaging in conversation, being observed by others while eating or drinking, and performing in front of others such as giving a speech
- fear, anxiety, or avoidance is persistant and lasts 6 months or longer
Agoraphobia - Answer - fear or marked anxiety in two of five situations: use of public transportation, being in an open space, being in an enclosed area, being in a crowd or standing in line, alone outside of the home
- symptoms must persist > 6 months and cause significant distress or impairment in social, occupational, or other important area of life functioning
Generalized Anxiety Disorder - Answer - excessive worry and anxiety for a period of at least 6 months
- 3 or more: on edge, restless, and keyed up, easily fatigued, mind goes blank - difficulty concentrating, irritability, tension in muscles, difficulty with sleep
Separation Anxiety Disorder - Answer - excessive and developmentally inappropriate fear and anxiety about loss of an attachment figure that persists in 6 months and children at least 4 months
- 3 or more: distress around separation from home or significant problem, fear that something bad will happen attachment figure, worry that something bad will happen, refusal or reluctance to go out alone, fear of being home alone, does not want to spend the night away from home, recurring nightmares of separation, somatization when left alone or anticipation of separation
Selective Mutism - Answer - consistent inability to speak in certain situations
- failure to speak results in decreased school/social/occupational performance
- failure to speak lasts at least 1 months apart from first month of school
- not secondary to language difficulty
- not due to another diagnosis or communication disorder
Non-pharmacological Interventions for Anxiety Disorders - Answer sensory integration, CBT, rational emotive therapy, mindfulness, skill acquisition, metacognition, restructuring strategies, symptom management, nutrition, exercise, systematic desensitization, family treatment, group therapy, psycho-education, acupuncture, energy work, breath work, yoga, meditation, interprofessional team approach to treatment
Barriers in Treatment for Panic Disorders and Phobias** - Answer establishing and maintaining a therapeutic alliance with the individual diagnosed with panic disorder is viewed as a key element in a successful intervention as well as educating the individual on the early signs of relapse
Side Effects of Anti-Anxiety Medication - Answer decrease in sex drive and ability to perform sexual acts
Psychosocial Factors that contribute to Anxiety Disorders - Answer - psychoanalytic: childhood fears, repressed material/impulses, unresolved unconscious conflicts
- behavioral: faculty, distorted, counterproductive thinking patterns, inability to cope
- existential: profound feelings of lack of meaning
Most Common Mental Disorder in US - Answer phobia (specific phobia)
How Individuals with Anxiety Disorders are Characterized - Answer (regardless of intelligence) characterized by others as "nervous" or "ineffective" or "awkward" in social situations leading to avoiding contact with others
Alzheimer's Disease - Answer - progressive and irreversible brain disorder characterized by gradual deterioration of memory, reasoning, language, and executive functioning; 6th leading cause of death
- due to malnutrition/dehydration/infection
- social cognition/social functioning/procedural memory may be preserved for extended periods of time
Frontotemporal (Pick Disease) - Answer - diagnosis: 60s
- signs and symptoms: impairments in socialization/self-care/and personal
Human Immunodeficiency Virus (HIV) - Answer - neuromotor features (severe incoordination, ataxia, motor slowing)
- loss of emotional control (aggressive/inappropriate affect or apathy)
- impaired executive abilities - slowed info processing = interference with complex disease management decisions
- comorbid disease = more functional impairments
Strategies for Delaying/Slowing Down Cognitive Decline - Answer public health approach to addressing lifestyle-related risk factors is recommended to delay or slow cognitive decline/dementia (physical inactivity, tobacco use, unhealthy diets, harmful use of alcohol, social isolation, and cognitive inactivity)
Delirium - Answer - disturbance in attention with decreased ability to focus, sustain, or shift attention
- an additional change in cognition (memory loss, disorientation, or language disturbance)
- perceptual disturbances (hallucinations paranoid thoughts)
- symptoms cannot be explained by a pre-existing or developing NCD
- medical evidence that disturbance is either caused by a medical condition, intoxication, or withdrawal from a substance
Types of Delirium - Answer - hyperactive: symptoms present with lethargy, increased daytime sleeping, or even depression
- hypoactive: include anxiety, agitation, combativeness, or hallucinations
- mixed: fluctuate between these patterns of activity level within the same day
Types of NCD asscoiated with Falls - Answer NCD due to Lewy body disease frequently experiences repeated falls and syncope and transient episodes of unexplained loss of consciousness
Criterion for diagnosing an NCD - Answer - decline in performance in one of more mild symptoms (complex attention, awareness, executive function, learning and memory, language, perceptual-motor abilities, and social cognition)
- cognitive deficits (major symptoms) cause some degree of impairment in occupational functioning and independence in everyday activities
- delirium cannot be the only cause of cognitive impairment
- rules out other disorders, such as depression or schizophrenia as the cause of cognitive impairment
Treatments for NCD - Answer - pharmacological treatment of major NCD depends on subtype, but mild/major NCD due to AD, Lewy body dementia, and Parkinson's may be prescribed cholinesterase inhibitors to prevent the breakdown or ACh in body
- higher levels of glutamate = AD uses memantine and cholinesterase inhibitor to target glutamate receptors to regulate amount of calcium moving into brain cells improving mental and ability to perform ADL
Obsessive-Compulsive Disorder - Answer - neuropsychiatric disorder where individuals experience "repetitive, unwanted, and intrusive thoughts, alongside related, irrational, excessive urges to complete certain behaviors"
- obsessions: persistent, unwanted, intrusive thoughts; mostly resolved by compulsions
- compulsion: irrational excessive behaviors repeated over and over to control/rid obsessions
Course and Prognosis for OCD - Answer - often starting in early childhood or adolescence
- first symptoms prior to age 20 (50%)
- misdiagnosis common due to comorbid psychiatric diagnoses
- course is chronic unless treated
- 40% symptom remission with treatment
Body Dysmorphic Disorder - Answer - severe preoccupation with perceived defect in physical appearance; bodily harm to "fix" perceived defect
caregivers living in the home, unwanted child, adopted/foster children, female caretakers (neglect/medical neglect), male caretakers (sexual abuse), trigger events, younger children
Type of Abuse Males versus Females are likely to Experience - Answer - males: physical abuse (other than sexual abuse)
- females: sexual, emotional abuse, and neglect
Maladaptive Outcomes for Complex Trauma - Answer - difficulty adapting to significant stress
- difficulty arousal regulation/modulation
- prolonged/extreme emotional tantrums
- disturbances in sleeping, eating, elimination
- poor impulse control
- difficulty understanding consequences
- head banging, body rocking, compulsive masturbation
Dental Hygiene and Toddlers for Complex Trauma - Answer lack of dental health and care for maltreated children manifests as a result of parental difficulty with reliable transportation, trouble with finances, distance to nearest dental clinic, diminished sense of value in dental health, lack of parent education on dental health; oral cavity pain, loss of function, infection
Conversion Disorder - Answer - referred to functional neurological symptom disorder or psychogenic movement disorder
- characterized by one or more symptoms relating to a motor or sensory impairment when all medical testing is considered normal (motor; tremors, dystonic [twisting, repetitive movements, or abnormal postures] movements, gait abnormalities, abnormal limb posturing, and weakness or paralysis)
Psychological Factors and Influence on Medical Conditions - Answer behavioral or psychological factors that can worsen other medical conditions (chronic stress increasing risk for hypotension → ignoring signs of a heart attack)
Factitious Disorder - Answer - Munchausen syndrome: people who exaggerate their symptoms not for financial gain but for increased sympathy
- Munchausen syndrome by proxy: exaggerating of an illness upon a child typically to gain sympathy for the caregiver
Somatoform Disorders and Healthcare Costs - Answer healthcare costs for people with somatoform disorder are twice those for people with other medical conditions in the U.S.
Most Reported Somatic Symptom - Answer pain
DSM-5 Diagnostic Criteria for Somatic Symptom Disorder - Answer - a perception of any somatic symptom being persistent for more than 6 months
- daily routines are greatly impacted by one or more perceived somatic symptoms
- constant exaggerated thoughts or behaviors related to the severe impact of one's somatic symptoms
- ongoing elevated anxiety about one's health or symptoms
- time-consuming increased expenditure of energy due to a fixation on disproportionate health conditions or symptoms
Important Components for Managing Somatic Symptoms - Answer reducing health-related anxieties, preoccupation with health concerns, and modifying or substituting maladaptive illness behaviors; cognitive behavioral therapy; dialectical behavior therapy
Anorexia Nervosa - Answer - profound refusal to maintain a normal body weight
- distorted body image
- food/calorie restriction in combination with excessive exercise
Bulimia Nervosa - Answer binge eating and purging of food to avoid weight gain
Defining Characteristics of Addiction - Answer - binge/in-toxification stage
- withdrawal/negative affect stage
- preoccupation/anticipation
Areas of the Brain Affected by Addiction - Answer basal ganglia (nucleus accumbens, ventral pallidum), amygdala, prefrontal cortex
Gambling Addiction and Quantity of Money - Answer - females with gambling use disorder are more likely than males to have comorbid depressive, bipolar, and anxiety disorder and to seek treatment
- increases in response to stress, depression, substance use, or abstinence leading to periods of heavy gambling and serious problems, total abstinence, and sometimes non problematic gambling leading to a false sense of invulnerability
Global Trends in the Estimated Prevalence of People who use Drugs and Those with Drug Use Disorders - Answer - any drug 52.2m
- marijuana 43.5m
- pain relievers 9.9m
- tranquilizers and sedatives 6.4m
- hallucinogens (LSD, PCP, E) 5.6m
- cocaine 5.5m
- stimulants 5.1m
- inhalants 2m
- methamphetamine 1.9m
- heroin 0.8m
