1. Assertive
    a behavior that promotes equality in human relationships, enabling us to act in our own best interests, to stang up for ourselves without indue anxiety, to express honest feeling confortably, to exercise personal rightswihout denying the rights of other
  2. Non assertive behavior
    sometimes called passive-seek to please othersat the expense of denying their own human basic rights.
  3. Aggresive behavior
    the individual defend their ownbasic rights by violating the basic rights of others
  4. Passive aggressive behavior
    the individual defend their own rghts by expressing resistance to social and occupational demands...the individual wont tell you straight forward what they are feeling but try to by being highly critical and sarcastic...ex. julie tells carmen to do a last minute essay for her, carmen is busy but tells julie yes...when julie ask for the paper carmen simply tells her she forgot to do it
  5. Behavior components of assertive behavior
    • eye contanct
    • bidy posture
    • distance/physical contact
    • gesture
    • facial expression
    • voice
    • fluency
    • timing
    • listening
    • thoughts
    • content
  6. Techniques that promote assertiveness
    • standing up for ones own rights
    • assuming responsibility for ones own statement
    • agreeing assertively
    • responding as a broken record
    • inquiring assertively
    • shiting from content to process
    • clouding/fogging
    • defusing
    • delaying assertively
    • respoding assertively with irony
  7. Assuming resposibility for ones owns statement
    ex. I dont want to go out with you tonight


    I cant go out with you tonight
  8. responding as a broken record
    -persistently repeating in a clam voice what is wanted

    • sales person: I want to help you save money by changing long distance services
    • you: I dont want to change my long distance service
    • sales: I cant believe you dont want to save money
    • you:I dont want to change my long distance service
  9. agreeing assertively
    • assertively accepting negative aspects about oneself; admitting when an error has been made
    • ex. You sure let the meeting get out of control. What a waste of time.
    • you: Yes,I didnt do a very good job of conducting the meeting today
  10. Inquiring assertively
    -seeking additional info about critical statements

    • ex. Co-worker-you made a real fool of yourself at the meeting last night
    • you- Oh really? Just what about my behavior offended you
    • Co worker- you were to dammed pushy
    • you- were you offended that I spoke for my beliefs, or is it because my beliefs are in direct opposition to yours?
  11. Shiting from content to process
    • changing the focus of the communication fromdiscussing the topic at hand to analyzing what is actually going on in the interaction
    • ex. wife tells hubby what time are you coming from dinner and he says get of my back...she respose sounds like to me we need to discuss some other things here, what are you really angry about?
  12. Clouding/fogging
    concurring with the crtics arguement without becoming defensive and without agreeing to change

    -ex. ms mau sample
  13. Defusing
    putting off further discussion with an angry individual until he/she is calm
  14. Delaying assertively
    putting off further discussion with another individual until one is calmer
  15. Responding assertively with irony
    EX. I bet you're one of them so called woman libbers, arent you

    woman- Why, yes. Thank you for noticing it
  16. Development of self esteem
    • Power-the persons needs to feel the control over their owns life
    • Significance- self esteem is enhance when the individual is loved, respected, and cared by significant other
    • Virtue- individual feels good about themselves when their actions reflect a set of personal, moral, and ethical values
    • Competence- postive self esteem developes out of ones ability to perform successfully or archieve self expectations and the expectations of others
    • Consistnetly set limits- a structured lifestyle demonstrates acceptance and caring and provides a feeling of security
  17. How can parents increase their children self esteem
    • A sense of competence- the child needs t feel is that they have accomplished their personal best effort
    • Unconditioned loved
    • A sense of survival- when the individual learn rom failure and grow in the knowledge that they are stronger for having experienced it
    • Realistic goals
    • Reality orientation- children should recognize a healthy balance between what they can posse and achieve, and what is beyond their capability or control
  18. Ericksons theory
    • Trust vs Mistrust birth-18m
    • Autonomy vs Shame and Doubt 18m-3yrs
    • Initiative vs Guilt 3-6yrs
    • Industry vs Inferioty 7-12 yrs
    • Identity vs Role confusion 12-20 yrs
    • Intamacy vs Isolation 20-30yrs
    • Generativity vs Stagnation 30-65yrs
    • Ego vs Despair 65-older
  19. Focal stimuli
    • is the immidiate concern that is causing the threat to self esteemand te stimulis that is endegaring the current behavior
    • ex. termincation of a signicant relationship, loss of employment, and failure to pass the state test
  20. Contextual stimuli
    are all of the other stimuli present in the persons enviroment that contribute to the behavior baing caused by the focal stimlus
  21. Residual stimuli
    are factors that may influence ones maladaptive behavior in responce to focal and contextual stimuli
  22. Boundaries
    physical boundaries include physical closeness, choiches, touching, sexual behavior, eye contact, privacy....mail.diary, bathroom, telephone

    Psychological boundaries- include beliefs, feelings, choices, needs, time alone, interest, spirutuallity
  23. Rigid boundaries
    the individual as a hard time trusting others, they reject new ideas or experiences, and often withdraw both emotionally or physical
  24. Flexible boundaries
    healthy boundaries are healthy that is the individual must let go of their boundaries and limits when appropiate
  25. Enmeshed boundaries
    occur when 2 peoples boundaries are so blended together that neither can be sure where one stops and the other beginsir individual boundaries may be blurredwith anothers.
  26. Stress or more properly a stressor is an external pressure that is brought to bear on the individuals and anxiety is the subjective emotional response to that stressor
  27. Types of anxiety disorders
    • Obsessive-compulsive disorder (OCD)
    • Generelazied Anxiety
    • Panic Disorder
    • Posttraumatic stress disorder (PTSD)
  28. Seratonin and GABA are decreased in clients with anxiety disorders
  29. Anxiety is more common in woman and girls, aswell as low socialeconomic class
  30. Anxiety is normal in all individual but is abnormal when???
    -It is out of propotion to the situation that is creating it...ex not driving ever again afer car accident

    -The anxiety intereres with social, occupational, or other important areas of functioning
  31. Panic D/O
    the disorder is characterized by recurrent panic attacks, the onset which is unpredictable, and manifested by intense apprehension, fear, or terror, often associated with feelings of impending doom and accompanied by intense physical discomfort....no need of a specific phobia
  32. Panic D/O
    • - the average onset is late 20
    • - may have attaks weekly or several times a week...
    • -D/O may last for years, months, few weeks
    • -many physical symptoms are accompanied when it occurs such as palpitations, sweating, trembling shaking...ect..
  33. Panic disorder with agoraphobia
    • characterized by symptoms of panic D/O, the client fears of being in places or situations from which escape might be difficult (or emberrasing) or help may be limited
    • -individual may become near or completly housebon or unable to leave the house unaccompanied
    • ex. being outside, home alone, being in a crowd, bridges, buses, car
  34. Generelized Anxiety D/O
    • is characterized by chronic unrealistic, and excessive worring
    • - symptoms have to exist for more than 6months
    • -onset may begin in childhood or adolescene, or age 20
  35. S&S of Generalized Anxiety D/O
    • Excessive worrying
    • Restleness
    • Easily fatigue
    • Difficult concentrating (mind going blank)
    • Irratability
    • Muscle tension
    • Sleep disturbances
  36. Psychodynamic theory for Generaliezed anxity d/o
    • inability for the ego to intervene with the conflict occurs between the id and the superego
    • -various reasons this occurs
    • ( unsatisfactory parent-child relationship, ego dev delayed, conditional love or provisional gratiication
  37. Cholecystokinin is found in patients with panic attacks aswell as abnormal elevations of blood lactate
    -norephinephrine also increases anxiety
  38. Phobia
    • fear cued by the presence or anticipation of a specific object or situation, exposure to which almost invariably provokes an immidiate anxiety response or panic attack even though the subject recognizesthat the ear is excessive or unreasonable. The phobic stimulus is avoided or indured withmarked distres
    • -onset 20-30yrs and more common in woman than men
  39. Social phobias and Specific phobias
    Social- is an excessive fear of situations in which a person might do something embarrasing or be evaluated negatively by others/ Onset late childhood and early adolescence, equally in men and woman

    Specific- and excessive or unreasonable fear when in the presence of or when anticipating an encounter o the object or situation....more in woman than men
  40. Castration anxiety
    Castration anxiety is the conscious or unconscious fear of losing all or part of the sex organs, or the function of such.
  41. Psychoanalytical, learning, and cognitive theory for phobias
    • Freud believed that child experiences normal incestuous feeling toward the oppsite sex parent (oedipal/electra complex) and fear or aggression from the same sex parent( castration anxiety), so the child places this fear or aggression into something more sage and neutral whhich becomes a phobic stimulus( done unconciousnessly)
    • Modern day psychoanalyst believe that unconcious fears may be expressed in a symbolic manner...ex woman as a phobia with water vessels....as a child she was raped in a boat

    Classical conditioning-after something as cause fear(unconditioned response) the person consiously avoids this harmless object to escape fear.

    Faulty thinking or irrational beliefs
  42. Obsessions
    unwanted, intrusive, persistent ideas, thoughts, impulses, or images that cause marked anxiety or distress...most common are repeated thoughts, repeated doubts, a need to have things in a particular order, aggressive or horric impulsions, and sexual imagery
  43. Compulsions
    Unwanted repetive behaviors patterns or mental acts that are intended to relieve anxiety not to provide pleasure or gratification
  44. OCD Obsessive compulsive disorder
    as recurrent obsession or compulsion that are severe enough to be time consuming or to cause marked distress or significant impairement, the individual recognizes this but because this reliefs some anxiety they continue to do it
  45. Passive and active avoidance for OCD
    • passive- the perso avoids or stays away from the source
    • active the person engages in behaviors that provide relief from the anxiety
  46. PTSD Posttraumatic stress disorder
    • deveopment o characteristics symtoms following exposure to an extreme traumatic stressor involving a personal threat to physical integrity or to the physical integrity of others
    • -ex. military combat, taken hostage, car accident, life threating illness
    • -excludes uncomplicated bereavament, marrige conlicts
    • can occur at any age
  47. Psychosocial theory for PTSD
    -this explains why certain people experiece PTSD while others dont

    • The traumatic experience
    • The individual
    • The recovery enviroment
  48. Most common type of therapy for OCD
    • SYstematic desensitition
    • Implosion therapy (flooding)
  49. Medication used for panic and generealized anxiety
    • -benzodiazepines are widely used for anxiety d/o but they can be addicting,
    • -buspirone(Buspar) is the only one not addicting but it takes 10-14days to take effect. (Generalized anxiety d/o)

    SSRI_antidepressants in treating Panic attacks are paroxetine(paxil), fluoxetine(prozac), sertraine(zoloft).

    antihypertensive- Clonidine- acute anxiety of opioid and nicotine withdrawal
  50. Medications for phobias
    • Most effectives are SSRI for social phobias
    • paroxetine and sertraline )Paxil and zoloft

    antihypertensive medication can be used such as propranolol and atenolol
  51. OCD medication
    SSRI such as fluoxetine (prozac), paroxetine( Paxil) and fluvoxamine ( )
  52. PTSD medications
    • SSRI Paroxetine and sertraline are the fist choice
    • Anxiolytics- Alprazolam has been presvribed for clients for its antidepressant and antipanic effects
    • antihypertensive in clinical trials it maked signigicant reductions on nightmares, hyperviligance, nsomnia, startle responses, and angry outbursts.
Card Set
Psych mental health nursing Chapter 15 16 and some of 30