Exam 2 - Mental Health

  1. 23-hour observation
    A short-term treatment that serves the patient in immediate but short-term crisis. This type of care admits individuals to an inpatient setting for as long as 23 hours during which time services are provided at a less-than-acute care level.
  2. ABCDE
    • An acronym for the basic framework of rational emotive behavior therapy.
    • A=activating event
    • B=belief system
    • C=dysfunctional consequences, functional consequences
    • D=
    • E=
  3. ABCs of psychological first aid
    Focusing on A (arousal), B (behavior), and C (cognition).
  4. absorption
    Movement of drug from the site of administration into plasma.
  5. accreditation
    Process by which a mental health agency is recognized or approved in accordance with established standards to be providing acceptable quality of care.
  6. acculturation
    Act or process of assuming the beliefs, values, and practices of another, usually dominant culture.
  7. acetylcholine
    The primary cholinergic neurotransmitter. Found in the greatest concentration in the peripheral nervous system, ACh provides the basic synaptic communication for the parasympathetic neurons and part of the sympathetic neurons, which send information to the central nervous system. An important neurotransmitter associated with cognitive functioning; disruption of cholinergic mechanisms damages memory in animals and humans.
  8. activating event
    The “A” in the ABCDE framework of rational emotive behavior therapy. It represents an external or internal stimulus. Not necessarily an actual event, it may be an emotion, or thought or expectation that is interpreted according to a set of beliefs.
  9. active listening
    Focusing on what the patient is saying in order to interpret and respond to the message in an objective manner while using techniques such as open-ended statements, reflection, and questions that elicit additional responses from the patient.
  10. acute stress
    • an intense biopsychosocial reaction to a threatening event, is time limited (usually less than a month), but can occur repeatedly. It can lead to physiologic overload, which in turn can have a negative impact on a person’s health.
    • Acute stress is associated with the “fight-or-flight” response. When the brain (amygdala and hippocampus) interprets an event as a threat, the hypothalamus and autonomic nervous system are signaled to secrete adrenaline, cortisol, and epinephrine. These hormones activate the sympathetic nervous system and physiologic stability is challenged. A “fight-or-flight” response occurs when the heart rate, blood pressure, and blood sugar increase. Energy is mobilized for survival. As the sympathetic system is activated, the parasympathetic is muted. After there is no longer a need for more energy and the threat is over, the body returns to a state of homeostasis.
  11. adaptive behavior
    Behavior that is composed of three skill types: conceptual, social, and practical skills.
  12. adherence
    An individual’s compliance to a therapeutic routine.
  13. advance care directives
    Treatment directives (living wills) and appointment directives (power of attorney or health proxies) that apply only if the individual is unable to make his or her own decisions because the patient is incapacitated or, in the opinion of two physicians, is otherwise unable to make decisions for himself or herself.
  14. advanced practice psychiatric–mental health registered nurses
    A licensed registered nurse who is educationally prepared at the graduate level and is nationally certified as a specialist by the American Nurses Credentialing Center (ANCC).
  15. adverse reactions
    • (adverse effects)
    • Unwanted medication effects that may have serious physiologic consequences.
  16. affect
    An expression of mood manifest in a person’s outward emotional expression; varies considerably both within and among different cultures.
  17. affinity
    Degree of attraction or strength of the bond between a drug and its biologic target.
  18. agoraphobia
    Fear of open spaces; commonly occurs with panic disorder.
  19. akathisia
    An extrapyramidal side effect characterized by the inability to sit still or restlessness; more common in middle-aged patients. Sometimes misdiagnosed as agitation or an increase in psychotic symptoms.
  20. allostasis
    The dynamic regulatory process that maintains homeostasis through a process of adaptation.
  21. amino acids
    Building blocks of proteins that have different roles in intraneuronal metabolism. Amino acids function as neurotransmitters in as many as 60% to 70% of synaptic sites in the brain.
  22. anger management
    A psychoeducational intervention for persons whose anger behavior is dysfunctional in some way (i.e., interfering with success in work or relationships) but not violent.
  23. anhedonia
    Inability to experience pleasure.
  24. assault
    The threat of unlawful force to inflict bodily injury on another. The threat must be imminent and cause reasonable apprehension in the individual.
  25. assertive community treatment
    A model that calls for a multidisciplinary clinical team approach to providing 24-hour, intensive community-based services to help patients meet the requirements of community living during reintegration.
  26. asylum
    Safe haven.
  27. attachment
    Emotional bond formed between children and their parental figures at an early age; attaining and retaining interpersonal connection to a significant person, beginning at birth.
  28. attention-deficit hyperactivity disorder (ADHD)
    A persistent pattern of inattention, hyperactivity, and impulsiveness; typically diagnosed based on teacher and parent reports and direct observation of the behavior patterns described.
  29. atypical antipsychotics
    Newer antipsychotics that are equally or more effective than conventional antipsychotics but have fewer side effects.
  30. augmentation
    A strategy of adding another medication to enhance effectiveness.
  31. autism spectrum disorder (ASD)
    Disorders characterized by neurodevelopmental delays that are typically diagnosed in childhood. Children with autism spectrum disorders may or may not have an intellectual disability, but they commonly show an uneven pattern of intellectual strengths and weaknesses.
  32. autonomic nervous system
    Part of the nervous system that regulates involuntary vital functions including cardiac muscle, smooth muscles, and glands. It is composed of the sympathetic and parasympathetic systems.
  33. basal ganglia
    Subcortical gray matter areas in both the right and the left hemisphere that contain many cell bodies or nuclei.
  34. behavior modification
    A specific therapy technique that can be applied to individuals, groups, or systems. The aim of behavior modification is to reinforce desired behaviors and extinguish undesired ones.
  35. behavior therapy
    Interventions that reinforce or promote desirable behaviors or alter undesirable ones.
  36. behaviorism
    A paradigm shift in understanding human behavior that was initiated by Watson, who theorized that human behavior is developed through a stimulus–response process rather than through unconscious drives or instincts.
  37. belief system
    The “B” in the ABCDE framework of rational emotive behavior therapy. Beliefs underlying thoughts and emotions are shaped by rationality, which is self-constructive, and irrationality, which is self-defeating.
  38. bibliotherapy
    The use of provider-assigned books and other reading materials to help individuals gain therapeutic benefit.
  39. bioavailability
    Amount of a drug that actually reaches the systemic circulation unchanged.
  40. biogenic amines
    Small molecules manufactured in the neuron that contain an amine group. These include dopamine, norepinephrine, and epinephrine (all synthesized from the amino acid tyrosine) and serotonin (from tryptophan).
  41. biologic markers
    Physical indicators of disturbances within the central nervous system that differentiate one disease state from another; found using diagnostic testing.
  42. biotransformation
    Metabolism of a drug or substance; the process by which the drug is altered and broken down into smaller substances, known as metabolites.
  43. board-and-care homes
    Facilities that provide 24-hour supervision and assistance with medications, meals, and some self-care skills but in which individualized attention to self-care skills and other activities of daily living is generally not available.
  44. body image
    How each individual perceives his or her own body, including such dimensions as size and attractiveness.
  45. boundaries
    Limits in which a person may act or refrain from acting within a designated time or place. Invisible barriers with varying permeabilities that surround family subsystems.
  46. boxed warning
    Serious adverse effects that can occur with the use of a specific medication; noted in issued warning in the package insert.
  47. brain stem
    Area of the brain containing the midbrain, pons, and medulla, which continues beneath the thalamus.
  48. breach of confidentiality
    Release of patient information without the patient’s consent in the absence of legal compulsion or authorization to release information.
  49. bridge employment
    • (paid work for those receiving a pension)
    • alleviates the negative consequences of retirement for those who are forced to retire involuntarily
  50. bullying
    Repeated, deliberate attempts to harm someone that are usually unprovoked. An imbalance in strength is a part of the pattern, with most victims having difficulty defending themselves.
  51. carrier protein
    A membrane protein that transports a specific molecule across the cell membrane.
  52. case finding
    Identifying people who are at risk for suicide to initiate proper treatment. Identification of depression and risk factors associated with suicide.
  53. case management
    Service model in which a case manager locates services, links the patient with these services, and then monitors the patient’s receipt of these services.
  54. catharsis
    A Freudian concept meaning release of feelings, as in the venting of anger.
  55. cerebellum
    Part of the brain that is responsible for controlling movement and postural adjustments; it receives information from all parts of the body.
  56. chemical restraint
    Use of medication to control patients or manage behavior.
  57. child abuse
    Any action that robs children of rights they should have including the rights to be and behave like a child; to be safe and protected from harm; and to be fed, clothed, and nurtured so the child can grow, develop, and fulfill his or her unique potential.
  58. child neglect
    A form of child abuse defined as failure to provide for a child’s physical, emotional, health care, or educational needs; failure to adequately supervise a child; or intentionally exposing a child to a dangerous environment.
  59. chronic stress
    an ongoing physiologic reaction to events resulting in “wear and tear” on the body and negatively impacts health and well-being. The adaptive physiologic changes that occur during acute stress become maladaptive when prolonged and contribute to the risk for illness. The relationship between chronic stress and illness was identified many years ago with the introduction of the general adaptation syndrome (GAS).
  60. chronic syndromes
    Symptom patterns that last for long periods of time. Medication-related movement disorders that develop from longer exposure to antipsychotic drugs.
  61. chronobiology
    Study and measure of time structures or biologic rhythms.
  62. circadian cycle
    A biologic system that has a 24-hour cycle.
  63. classical conditioning
    A learning situation in which an unconditioned stimulus initially produces an unconditioned response; over time, a conditioned response is elicited for a specific stimulus (Pavlov).
  64. clearance
    Total amount of blood, serum, or plasma from which a drug is completely removed per unit of time.
  65. clinical reasoning
    Using critical thinking and reflection to address patient problems and interventions.
  66. closed group
    A group in which all the members begin at one time. New members are not admitted after the first meeting.
  67. cognition
    A high level of intellectual processing in which perceptions and information are acquired, used, or manipulated; for Beck, verbal or pictorial events in the stream of consciousness. A person’s ability to think and know. An internal process of perception, memory, and judgment through which an understanding of self and the world is developed.
  68. cognitive aging
    a process of gradual, ongoing, yet highly variable changes in cognitive functions that occur as people get older. Cognitive aging is a life-long process beginning in utero. Normal aging does not impair consciousness, alertness, or attention. Health and environmental factors over a life span influence cognitive aging. Individual factors, including genetics, culture, medical comorbidities, acute illness, customary activity levels, socioeconomic status, education, and personality may modify the development or expression of age-related changes in cognition.
  69. cognitive distortions
    Automatic thoughts generated by organizing distorted information or inaccurate interpretation of a situation.
  70. cognitive interventions
    • (cognitive interventions or cognitive therapy)
    • Interventions or psychotherapy that aims to change or reframe an individual’s automatic thought patterns that develop over time and that interfere with the ability to function optimally.
  71. cognitive reserve
    The brain’s ability to operate effectively even when there is disruption in functioning.
  72. cognitive theory
    An outgrowth of different theoretic perspectives, including the behavioral and the psychodynamic, that attempts to link internal thought processes with human behavior.
  73. cognitive triad
    Thoughts about oneself, the world, and the future.
  74. cohesion
    The ability of a group to stick together.
  75. coleadership
    When two people share responsibility for leading a group.
  76. commitment to treatment statement
    Statement in which a patient verbally or in writing agrees to seek treatment or access emergency services if needed.
  77. communication blocks
    Interruptions in the content flow of communication, such changes in topic that either the nurse or patient makes.
  78. communication disorders
    Disorders that involve speech or language impairments.
  79. communication pathways
    An aspect of group interaction based on interaction patterns related to who is most liked in the group, who occupies a position of power, what subgroups have formed, and who is isolated from the group.
  80. competence
    The degree to which the patient is able to understand and appreciate the information given during the consent process; the patient’s cognitive ability to process information at a specific time; the patient’s ability to gather and interpret information and make reasonable judgments based on that information to participate fully as a partner in treatment.
  81. compliance
    • (adherence)
    • An individual’s compliance to a therapeutic routine.
  82. complicated bereavement
    • (complicated grief)
    • A reaction to the loss of a loved one in which a person is frozen or stuck in a state of chronic mourning.
  83. compliments
    Affirmations of the patient.
  84. confidentiality
    An ethical duty of nondisclosure; the patient has the right to disclose personal information without fear of it being revealed to others.
  85. conflict resolution
    A specific type of counseling in which the nurse helps the patient resolve a disagreement or dispute.
  86. connections
    Mutually responsive and enhancing relationships.
  87. containment
    The process of providing safety and security; involves the patient’s access to food and shelter.
  88. content themes
    Repetition of concerns or feelings that occur within the therapeutic relationship. Themes may emerge as symbolic representations of fears.
  89. conventional antipsychotics
    Also known as typical antipsychotics, “older” medications used to treat psychotic disorders with more side effects than “newer” atypical antipsychotics.
  90. coordination of care
    The integration of appropriate services so that individualized care is provided. When several agencies are involved, this allows a person’s needs to be met without duplication of services.
  91. cortex
    Outermost surface of the cerebrum of the mature brain.
  92. counseling
    • (counseling interventions)
    • Specific time-limited interactions between a nurse and a patient, family, or group experiencing intermediate or ongoing difficulties related to their health or well-being.
  93. countertransference
    The therapist or nurse’s reactions to a patient that are based on interpersonal experiences, feelings, and attitudes. It can significantly interfere with the nurse–patient relationship.
  94. crisis intervention
    A specialized short-term (usually no longer than 6 hours) goal-directed therapy designed to assist patients in an immediate manner; focuses on stabilization, symptom reduction, and prevention of relapse requiring inpatient services.
  95. crisis intervention teams
    • (CIT)
    • Teams that train police officers to recognize and intervene in crisis situations in the community and determine whether emergency psychiatric services are needed.
  96. crystallized intelligence
    • knowledge such as language skills or knowledge about a particular topic
    • Crystallized intelligence remains fairly stable with modest declines in later life.
  97. cultural brokering
    Act of bridging, linking, or mediating between groups or individuals of different cultural systems for the purpose of reducing conflict or producing change. Cultural competence is a set of academic and interpersonal skills that are respectful of and responsive to the health belief practices and cultural and linguistic needs of diverse patients to bring about positive health care outcomes.
  98. cultural explanations
    perceived causes for symptoms
  99. cultural identity
    A set of cultural beliefs with which one looks for standards of behavior; many consider themselves to have multiple cultural identities.
  100. cultural idiom of distress
    A linguistic term, phrase, or a way of talking about suffering among individuals of a cultural group (DSM-5).
  101. cultural syndrome
    A cluster or group of co-occurring symptoms found in a specific cultural group, community, or context.
  102. cytochrome P450 (CYP450) system
    A set of microsomal enzymes (usually hepatic) referred to as CYP1, CYP2, and CYP3.
  103. cytokines
    messengers that signal the brain and serve as mediators between immune and nerve cells.
  104. debriefing
    The reconstruction of the traumatic events by the victim as a psychological intervention.
  105. deescalation
    An interactive process of calming and redirecting a patient who has an immediate potential for violence directed at others or self.
  106. defense mechanisms
    Coping styles; the automatic psychological process protecting the individual against anxiety and creating awareness of internal or external dangers or stressors.
  107. deinstitutionalization
    Release of patients with severe and persistent mental illness from state mental hospitals into the community for treatment, support, and rehabilitation as the result of a national movement that began in the 1960s.
  108. depersonalization
    A nonspecific experience in which the individual loses a sense of personal identity and feels strange or unreal.
  109. depression
    The primary mood of depressive disorders defined as an overwhelming state of sadness, loss of interest or pleasure, feelings of guilt, disturbed sleep patterns and appetite, low energy, and an inability to concentrate.
  110. depressive disorders
    Also referred to as unipolar depression, a specific subset of mood disorders consisting of major depression, dysthymia, and depression not otherwise specified (NOS).
  111. desensitization
    A rapid decrease in drug effects that may develop within a few minutes of exposure to a drug.
  112. deteriorating relationship
    A type of nontherapeutic relationship with several defined phases during which the patient and nurse feel very frustrated and keep varying their approach with each other in an attempt to establish a meaningful relationship.
  113. developmental crisis
    A significant maturational event, such as leaving home for the first time, completing school, or accepting the responsibility of adulthood.
  114. developmental delays
    An impairment of normal growth and development that may not be reversible. Delays slow a child’s progress and can interfere with the development of self-esteem.
  115. diathesis
    A genetic predisposition that increases susceptibility to developing a disorder.
  116. differentiation of self
    An individual’s resolution of attachment to his or her family’s emotional chaos. It involves an intrapsychic separation of thinking from feelings and an interpersonal freeing of oneself from the chaos.
  117. direct leadership
    The leader controls the interaction of the group by giving directions and information and allowing little discussion.
  118. disconnections
    Lack of mutually responsive and enhancing relationships.
  119. disruptive mood dysregulation disorder
    Persistent irritability and frequent episodes of extreme verbal and behavior outburst (children)
  120. distraction
    The purposeful focusing of attention away from undesirable sensations.
  121. distribution
    The amount of a drug that may be found in various tissues at the site of the drug action for which it is intended.
  122. dopamine
    An excitatory neurotransmitter found in distinct regions of the central nervous system involved in cognition, motor, and neuroendocrine function.
  123. dosing
    Administration of medication over time so that therapeutic levels may be achieved or maintained without reaching toxic levels.
  124. drug–drug interaction
    Reaction of two or more drugs with each other; may cause unexpected side effects. Can occur if one substance inhibits an enzyme system.
  125. DSM-5
    Abbreviation for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, which provides revised diagnostic criteria for mental disorders.
  126. dual process model
    • A model of bereavement where a person adjusts to loss by oscillating between loss-
    • orientated coping that includes preoccupation with the deceased and restoration-oriented coping in which the bereaved is preoccupied with stressful events as a result of the death.
  127. dyad
    A group of only two people who are usually related, such as a married couple, siblings, or parent and child.
  128. dysfunctional
    The state of a group, such as a family, whose interactions, decisions, or behaviors interfere with the positive development of the group as a whole and its individual members.
  129. dysfunctional consequences
    Part of the “C” in the ABCDE framework of rational emotive behavior therapy. The result of the interaction between A (an activating event) and B (the person’s belief system) that follows from absolute, rigid, irrational beliefs.
  130. dyslexia
    Significantly lower score for mental age on standardized test in reading that is not caused by low intelligence or inadequate schooling.
  131. dysphoric
    • (mood)
    • Depressed, disquieted, or restless.
  132. dystonia
    An impairment in muscle tone that is generally the first extrapyramidal symptom to occur, usually within a few days of initiating an antipsychotic. Dystonia is characterized by involuntary muscle spasms, especially of the head and neck muscles.
  133. early intervention programs
    Community outreach efforts designed to work with infants and preschool-aged children and their caretakers to foster healthy physical, psychological, social, and intellectual development.
  134. efficacy
    Ability of a drug to produce a response.
  135. elder mistreatment
    Actions (or inaction) by caregivers or trusted persons that cause harm or the possibility of harm to a vulnerable older adult.
  136. e-mental health
    The use of electronics and the Internet to provide assessment and interventions.
  137. emotional cutoff
    If a member cannot differentiate from his or her family, that member may flee from the family either by moving away or avoiding personal subjects of conversation. A brief visit from parents can render these individuals helpless.
  138. emotional well-being
    the ability to cope with stress through skills and strategies.
  139. emotion-focused coping
    A type of coping in which a person reduces stress by reinterpreting the situation to change its meaning.
  140. emotions
    Psychophysiologic reaction that defines a person’s mood and can be categorized as negative (anger, fright, anxiety guilt, shame, sadness, envy, jealousy, and disgust), positive (happiness, pride, relief, and love), borderline (hope, compassion, empathy, sympathy, and contentment), or nonemotions (confidence, awe, confusion, excitement).
  141. empathic linkage
    Ability to feel in oneself the feelings being expressed by another person or persons.
  142. empathy
    The ability to experience, in the present, a situation as another did at some time in the past; the ability to put oneself in another person’s circumstances and feelings.
  143. empty nest
    A home devoid of children and caregiving responsibilities.
  144. encopresis
    Soiling clothing with feces or depositing feces in inappropriate places.
  145. enuresis
    Involuntary excretion of urine after the age at which a child should have attained bladder control.
  146. environmental well-being
    involves living in pleasant, stimulating environments that support a healthy life style.
  147. enzymes
    Any of numerous proteins that act as catalysts for physiologic reactions and can be targets for drugs.
  148. epidemiology
    The study of patterns of disease distribution and determinants of health within populations; contributes to the overall understanding of the mental health status of population groups, or aggregates, and associated factors.
  149. ethnopsychopharmacology
    The study of cultural variations and differences that influence the effectiveness of pharmacotherapies used in mental health; includes genetics and psychosocial factors.
  150. euphoric
    An exaggerated feeling of well-being.
  151. euthymic
    • (mood)
    • A normal mood.
  152. exception questions
    Questions used to help the patient identify times when whatever is bothering him or her is not present or is present with less intensity based on the underlying assumption that during these times the patient is usually doing something to make things better.
  153. excretion
    The removal of drugs from the body either unchanged or as metabolites.
  154. exposure therapy
    The treatment of choice for agoraphobia in which the patient is repeatedly exposed to real or simulated anxiety-provoking situations until he or she becomes desensitized and anxiety subsides.
  155. extended family
    Several nuclear families who may or may not live together and who function as one group.
  156. external advocacy system
    Organizations that operate independently of mental health agencies and serve as advocates for the treatment and rights of mental health patients.
  157. extrapyramidal motor system
    Collection of neuronal pathways that provides significant input in involuntary motor movements; a bundle of nerve fibers connecting the thalamus to the basal ganglia and cerebral cortex.
  158. extrapyramidal symptoms
    • (EPS)
    • Acute abnormal movements developing early in the course of treatment with antipsychotic agents. Include dystonia, pseudoparkinsonism, and akathisia.
  159. family development
    A broad term that refers to all the processes connected with the growth of a family, including changes associated with work, geographic location, migration, acculturation, and serious illness.
  160. family dynamics
    The patterned interpersonal and social interactions that occur within the family structure over the life of a family.
  161. family life cycle
    A process of expansion, contraction, and realignment of relationship systems to support the entry, exit, and development of family members.
  162. family preservation
    Efforts made by professionals to preserve the family unit by preventing the removal of children from their homes through parental support and education and through work to facilitate a secure attachment between the child and parent.
  163. family projection process
    In a triangulated family situation, the triangulated member becomes the center of family conflicts.
  164. family structure
    According to Minuchin, the organized pattern within which family members interact.
  165. fetal alcohol syndrome
    A syndrome that occurs in infants whose mothers abuse alcohol during pregnancy; includes symptoms such as permanent brain damage, often resulting in mental retardation.
  166. fidelity
    Faithfulness to obligations and duties.
  167. financial well-being
    satisfaction with present and future situations. What the nurse needs to ascertain is not specific dollar amounts but whether the patient feels stressed by finances and has enough for basic needs.
  168. first-pass effect
    Metabolism of part of oral drugs after being absorbed from the gastrointestinal tract and carried through the portal circulation to the liver. Only part of the drug dose reaches systemic circulation.
  169. flooding
    A technique used to desensitize the patient to the fear associated with a particular anxiety-provoking stimulus. Desensitizing is done by presenting feared objects or situations repeatedly without session breaks until the anxiety dissipates.
  170. fluid intelligence
    • processing current or new information
    • Fluid intelligence involves thinking logically and solving problems.
    • Declines in fluid intelligence begin earlier and are more gradual throughout the lifespan
  171. formal group roles
    The designated leader and members of a group.
  172. formal operations
    The ability to use abstract reasoning to conceptualize and solve problems.
  173. formal support systems
    Large organizations that provide care to individuals, such as hospitals and nursing homes.
  174. frontal, parietal, temporal, and occipital lobes
    Lobes of the brain located on the lateral surface of each hemisphere.
  175. functional consequences
    Part of the “C” in the ABCDE framework of rational emotive behavior therapy. The results of the interaction between A (an activating event) and B (a person’s belief system) that follow from flexible, rational beliefs.
  176. functional imaging
    The aspect of neuroimaging that visualizes processing of information.
  177. functional status
    Extent to which a person has the ability to carry out independent personal care, home management, and social functions in everyday life in a way that has meaning and purpose.
  178. GABA
    Gamma-aminobutyric acid, the primary inhibitory neurotransmitter for the central nervous system (CNS). The pathways of GABA exist almost exclusively in the CNS, with the largest GABA concentrations in the hypothalamus, hippocampus, basal ganglia, spinal cord, and cerebellum.
  179. general adaptation syndrome
    • (GAS)
    • Hans Seyle, who is credited with initiation of the study of stress, defined stress as a nonspecific response to an irritant, a perceived danger, or a life threat. He called stress evoked by positive emotions or events eustress and stress evoked by negative feelings and events distress. He showed that corticosteroid secretion from the pituitary gland increased during stress and contributed to development of illnesses. Seyle described this process as general adaptation syndrome (GAS), which he defined as consisting of three stages:
    • the alarm reaction (a threat is perceived, and the body responds physiologically),
    • stage of resistance (coping mechanisms are used to try to reestablish homeostasis), and
    • stage of exhaustion (occurs if homeostasis is not achieved)
    • This early work set the stage for our understanding of the role of the hypothalamic–pituitary–adrenal (HPA) in chronic stress.
  180. genetic susceptibility
    A concept that suggests that an individual may be at increased risk for a psychiatric disorder based on genetic transmission.
  181. genogram
    A multigenerational schematic diagram that lists family members and their relationships.
  182. gerotranscendence
    A concept of Erikson; continued growth in dimensions such as spirituality and inner strength during old age.
  183. glutamate
    The most widely distributed excitatory neurotransmitter; the main transmitter in the associational areas of the cortex.
  184. group themes
    The collective conceptual underpinnings of a group that express the members’ underlying concerns or feelings, regardless of the group’s purpose.
  185. groupthink
    The tendency of many groups to avoid conflict and adopt a normative pattern of thinking that is often consistent with the group leader’s ideas.
  186. guided imagery
    The purposeful use of imagination to achieve relaxation or direct attention away from undesirable sensations.
  187. half-life
    The time required for plasma concentrations of a drug to be reduced by 50%.
  188. hippocampus
    Subcortical gray matter embedded within each temporal lobe of the brain that may be involved in determining the best way to store information, especially the emotions attached to a memory.
  189. histamine
    A neurotransmitter derived from the amino acid histidine that originates predominantly in the hypothalamus and projects to all major structures in the cerebrum, brain stem, and spinal cord. Its functions are not well known, but it appears to have a role in autonomic and neuroendocrine regulation.
  190. home visits
    Delivery of nursing care in a patient’s living environment.
  191. homeostasis
    The body’s tendency to resist physiologic change and hold bodily functions relatively consistent, well-coordinated, and usually stable. Introduced as a concept by Walter Cannon in the 1930s.
  192. hypnotics
    Medication that causes drowsiness and facilitates the onset and maintenance of sleep.
  193. ideation to action theories
    examine factors that identify those who are most likely to attempt suicide. These emerging theories are supported by research and provide a basis for discriminating between those who are thinking about suicide versus those who are likely to engage in suicidal acts.
  194. implosive therapy
    A provocative technique useful in treating agoraphobia in which the therapist identifies individual phobic stimuli for the patient and then presents highly anxiety-provoking imagery in a dramatic, vivid fashion.
  195. incidence
    A rate that includes only new cases that have occurred within a clearly defined time period.
  196. incompetent
    A person is legally determined not to be able to understand and appreciate the information given during the consent process.
  197. indirect leadership
    Leader who primarily reflects the group members’ discussion and offers little guidance or information to the group.
  198. individual roles
    Group roles that either enhance or detract from the group’s functioning but have nothing to do with either the group task or maintenance.
  199. inducer
    Drugs or substances that speed up metabolism, which in turn increases the clearance of the substrate and decreases its plasma level.
  200. informal caregivers
    Unpaid individuals who provide care.
  201. informal group roles
    Positions within the group with implicit rights and duties that can either help or hinder the group’s process. These positions are not formally sanctioned.
  202. informal support systems
    Family members, friends, and neighbors who can provide care and support to an individual.
  203. informed consent
    The right mandated by state laws for a patient to determine what shall be done with one’s own body and mind. To provide informed consent, the patient must be given adequate information on which to base decisions about care and actively participate in the decision-making process.
  204. inhibitor
    Drugs or substances that slow down metabolism, which in turn decreases the clearance of the substrate and elevates its plasma level.
  205. in-home mental health care
    The provision of skilled mental health nursing care under the direction of a psychiatrist or physician for individuals in their residences. Emphasizes personal autonomy of patient.
  206. insight
    The ability of the individual to be aware of his or her own thoughts and feelings and to compare them with the thoughts and feelings of others.
  207. institutionalization
    The forced confinement of individuals for long periods of time in large state hospitals. This was the primary treatment for people with mental illness in the period from 1900 to 1955.
  208. instrumental aggression
    Aggression that provides some reward or advantage to the aggressor, is premeditated, and is unrelated to the person’s pain.
  209. Integrated Bereavement Theory
    • consists of five stages:
    • 1. Shock and disbelief
    • 2. Awareness of loss
    • a. Separation anxiety predominates
    • b. Intense physical, emotional, social, and cognitive response
    • c. Identification with the deceased
    • 3. Conservation-withdrawal
    • d. Social withdrawal
    • e. Consciously and unconsciously the bereaved understand his/her loved one has died
    • f. Little strength to do every day activities
    • g. Closely resembles clinical depression
    • h. Turning point—a conscious process of deciding how the death is viewed and integrated into one’s life
    • 4. Healing
    • i. Acceptance of the loss intellectually
    • j. Acceptance of the loss emotionally
    • k. Change in the world view to match his/her reality
    • 5. Renewal
    • l. Increase in self-esteem
    • m. Takes charge and is responsible for his/her life
    • n. New level of functioning and self-awareness
    • o. Renewed vitality
  210. integrated care
    a treatment delivery model that combines medical and psychiatric treatment to improve access to medical care for people with psychiatric illnesses. In a fully integrated care model, medical and psychiatric providers are located in the same facility and share a common medical record, so that the patient can see both providers in one day if necessary.
  211. intellectual disability
    Limitations in intellectual functioning and adaptive behavior that develop before the age of 18 years. The term is currently used interchangeably with mental retardation.
  212. intellectual well-being
    The nurse can assess for intellectual well-being by determining the extent that the patient recognizes his or her creative abilities and is able to learn new knowledge and skills.
  213. intensive case management
    An approach targeted for adults with serious mental illnesses or children with serious emotional disturbances. Managers of such cases have fewer caseloads and higher levels of professional training than do traditional case managers.
  214. intensive outpatient program
    Program focused on continued stabilization and prevention of relapse in vulnerable individuals who have returned to their previous lifestyle (i.e., job or school), usually with sessions running 2 to 3 days per week and lasting 3 to 4 hours per day.
  215. intensive residential services
    Intensively staffed residential care and mental health services that may include medical, nursing, psychosocial, vocational, recreational, or other support services. May be short or long term.
  216. internal rights protection system
    Patient protective mechanisms developed by the U.S. mental health care system’s organizations to help combat any violation of mental health patients’ rights, including investigating any incidents of abuse or neglect.
  217. interoceptive conditioning
    Pairing a somatic discomfort, such as dizziness or palpitations, with an impending panic attack.
  218. Interpersonal Psychological Theory of Suicidal Behavior
    • (IPTS)
    • introduced by Thomas Joiner in 2005, proposes that three interacting factors indicate a high risk of suicide—
    • thwarted belongingness,
    • perceived burdensomeness, and
    • acquired capability.
  219. thwarted belongingness
    • (part of Interpersonal Psychological Theory of Suicidal Behavior)
    • describe alienation from social relationships or experiences; the human need to belong is not being met. It refers to an individual’s feelings of loneliness and isolation, as well as a lack of reciprocal, caring, and meaningful relationships.
  220. perceived burdensomeness
    • (part of Interpersonal Psychological Theory of Suicidal Behavior)
    • the perception that the individual is a burden to others.
  221. acquired capability for suicide
    • (part of Interpersonal Psychological Theory of Suicidal Behavior)
    • develops over time and involves a heightened sense of fearlessness and a high pain threshold
  222. interpersonal relations
    Characteristic interaction patterns that occur between human beings that are the basis of human development and behavior and the health or sickness of one’s personality.
  223. intrinsic activity
    The ability of a drug to produce a biologic response when it becomes attached to its receptor.
  224. introspective
    The self-examination of personal beliefs, attitudes, and motivations.
  225. involuntary commitment
    The confined hospitalization of a person without his or her consent but with a court order (because the person has been judged to be a danger to him- or herself or others).
  226. inwardly directed anger
    Anger that is stifled despite strong arousal.
  227. judgment
    The ability to reach a logical decision about a situation and to choose a course after looking at and analyzing various possibilities.
  228. justice
    Duty to treat all fairly, distributing the risks and benefits equally.
  229. label avoidance
    Type of stigma that occurs when an individual avoids treatment or care in order not to be labeled as being mentally ill.
  230. labile
    • (lability of mood)
    • Changeable mood.
  231. learning disorder
    A discrepancy between actual achievement and expected achievement that is based on a person’s age and intellectual ability.
  232. least restrictive environment
    The patient has the right to be treated in the least restrictive environment possible for the exercise of free will; an individual cannot be restricted to an institution when he or she can be successfully treated in the community.
  233. libido
    The energy or psychic drive associated with the sexual instinct that resides in the id, literally translated from Latin to mean “pleasure” or “lust.”
  234. limbic system
    • (limbic lobe)
    • A “system” of several small structures within the brain that work in a highly organized way. These structures include the hippocampus, thalamus, hypothalamus, amygdala, and limbic midbrain nuclei.
  235. linguistic competence
    The ability to communicate in a way that is easily understood by diverse audiences.
  236. living will
    An advanced care directive that states what treatment should be omitted or refused in the event that a person is unable to make those decisions because of incapacitation.
  237. locus coeruleus
    A tiny cluster of neurons that fans out and innervates almost every part of the brain, including most of the cortex, the thalamus and hypothalamus, the cerebellum, and the spinal cord.
  238. loss-oriented coping
    Part of the dual process model of bereavement that includes preoccupation with the deceased.
  239. maintenance roles
    The informal role of group members that encourages the group to stay together.
  240. major depressive disorder
    A depressed mood or a loss of interest or pleasure in nearly all activities for at least 2 weeks. Four of seven additional symptoms must be present: disruption in sleep, appetite (or weight), concentration, or energy; psychomotor agitation or retardation; excessive guilt or feelings of worthlessness; and suicidal ideation.
  241. maladaptive anger
    Excessive outwardly directed anger or suppressed anger; linked to psychiatric conditions, such as depression, as well as medical conditions.
  242. medical battery
    Intentional and unauthorized (without informed consent) treatment that is harmful or offensive.
  243. medical home
    treatment setting that uses a team approach to deliver comprehensive patient-centered care that addresses all aspects of patients’ health-related needs. Treatment teams in medical homes may consist of physicians, primary care and psychiatric advanced practice nurses, pharmacists, nutritionists, social workers, and care coordinators, all of whom collaborate to identify patients’ treatment needs and deliver comprehensive care. When medical and psychiatric care is integrated in a medical home, a patient’s plan of care addresses both psychiatric and physical treatment goals, coordination of care across settings, regular treatment team meetings to ensure ongoing communication between the primary care and psychiatric providers, and tracking of referrals and follow-up appointments.
  244. metabolism
    Biotransformation, or the process by which a drug is altered and broken down into smaller substances, known as metabolites.
  245. metabolites
    Result when drugs are altered and broken down into smaller substances by metabolism. Substance necessary for or taking part in a particular metabolic process.
  246. middle-old
    A term used to describe adults ages 75 to 84 years.
  247. milieu therapy
    An approach that provides a stable and coherent social organization to facilitate an individual’s treatment; often used interchangeably with therapeutic environment. The design of the physical surroundings, structure of patient activities, and promotion of a stable social structure and cultural setting enhance the setting’s therapeutic potential.
  248. miracle questions
    Patients are asked to use their imagination in crafting their response to very specific questions about a scenario.
  249. modeling
    Pervasive imitation; one person trying to be similar to another person.
  250. mood
    The prominent, sustained, overall emotions that a person expresses and exhibits; influences one’s perception of the world and how one functions.
  251. moral treatment
    An approach to curing mental illness, popular in the 1800s, that was built on the principles of kindness, compassion, and a pleasant environment.
  252. motor tics
    Usually quick, jerky movements of the eyes, face, neck, and shoulders, although they may involve other muscle groups as well.
  253. multigenerational transmission process
    The transmission of emotional processes from one generation to the next.
  254. negligence
    A breach of duty of reasonable care for a patient for whom the nurse is responsible that results in personal injuries. A clinician who does get consent but does not disclose the nature of the procedure and the risks involved is subject to a negligence claim.
  255. neurocircuitry
    The complex neural functional networks that link brain structures, including the prefrontal cortex, striatum, hippocampus, and amygdala. Research indicates that a dysfunctional neurocircuitry underlies most psychiatric disorders.
  256. neurohormones
    Hormones produced by cells within the nervous system, such as antidiuretic hormone (ADH).
  257. neuromodulators
    Chemical messengers that make the target cell membrane or postsynaptic membrane more or less susceptible to the effects of the primary neurotransmitter.
  258. neurons
    Nerve cells responsible for receiving, organizing, and transmitting information. Each neuron has a cell body, or soma, which holds the nucleus containing most of the cell’s genetic information.
  259. neuropeptides
    Short chains of amino acids that exist in the central nervous system and have a number of important roles, including as neurotransmitters, neuromodulators, or neurohormones.
  260. neurosis
    A category used by Freud and his followers to define those with less severe mental illness but who were often distressed about their problems.
  261. nonmaleficence
    The duty to cause no harm, both individually and for all.
  262. nontherapeutic relationship
    A nontrusting relationship between the nurse and patient. Both feel very frustrated and keep varying their approach with each other in an attempt to establish a meaningful relationship.
  263. nonverbal communication
    The gestures, expressions, and body language used in communications.
  264. norepinephrine
    An excitatory neurochemical that plays a major role in generating and maintaining mood states. Heavily concentrated in the terminal sites of sympathetic nerves, it can be released quickly to ready the individual for a fight-or-flight response to threats in the environment.
  265. normalization
    Teaching families what are normal behaviors and expected responses.
  266. nuclear family emotional process
    Patterns of emotional functioning in a family within single generations.
  267. nursing process
    The basis of clinical decision-making for evidence-based practice.
  268. object relations
    The psychological attachment to another person or object.
  269. occupational well-being
    involves personal satisfaction and enrichment derived from one’s work. The nurse should document the occupation the patient is now in as well as a history of jobs. If the patient has changed jobs frequently, the nurse should ask about the reasons. Perhaps the patient has faced such problems as an inability to focus on the job at hand or to get along with others. If so, such issues require further exploration.
  270. old-old
    A term used to describe adults ages 85 years and older.
  271. open communication
    Staff and patient willingly share information about relevant topics.
  272. open group
    A group in which new members can join at any time, and old members may leave at different sessions.
  273. operant behavior
    A type of learning that is a consequence of a particular behavioral response, not a specific stimulus.
  274. orientation phase
    The first phase of the nurse–patient relationship in which the nurse and the patient get to know each other. During this phase, the patient develops a sense of trust.
  275. oscillation
    Part of the dual process model of bereavement that involves a person moving between the process of confronting (loss-oriented coping) and avoiding (restoration-oriented coping) the stresses associated with bereavement.
  276. outpatient detoxification
    A specialized form of partial hospitalization for patients requiring medical supervision during withdrawal from alcohol or other addictive substances, with or without use of a 23-hour bed during the initial withdrawal phase.
  277. outwardly directed anger
    Anger expression particularly the hostile, attacking forms.
  278. panic attacks
    Sudden, discrete periods of intense fear or discomfort that are accompanied by significant physical and cognitive symptoms.
  279. panic control treatment
    Intentional exposure through exercise to panic-invoking sensations such as dizziness, hyperventilation, tightness in chest, and sweating.
  280. parasuicide
    Deliberate, apparent attempt at suicide, commonly called a suicidal gesture, in which the aim is not death (e.g., taking a sublethal drug); also called parasuicidal behavior.
  281. partial agonists
    A drug that has some intrinsic activity (although weak) to initiate the same response in the body as a chemical that is normally present.
  282. partial hospitalization
    A time-limited (usually full or half day), ambulatory, active treatment program that offers therapeutically intensive, coordinated, and structured clinical services for patients with acute psychiatric symptoms who are experiencing a decline in social or occupational functioning, who cannot function autonomously on a daily basis, or who do not pose imminent danger to themselves or others. The aim is patient stabilization without hospitalization or a reduced length of inpatient care.
  283. passive listening
    A nontherapeutic mode of interaction that involves sitting quietly and allowing the patient to talk without focusing on guiding the thought process; includes body language that communicates boredom, indifference, or hostility.
  284. paternalism
    The belief that knowledge and education authorizes professionals to make decisions for the good of the patient.
  285. patient observation
    The ongoing assessment of the patient’s mental status to identify and subvert any potential problem.
  286. peer support services
    peer assistance programs Programs developed by state nurses’ associations to offer consultation, referral, and monitoring for nurses whose practice is impaired or potentially impaired because of the use of drugs or alcohol or a psychological or physiologic condition.
  287. persistent depressive disorder
    • (persistent depressive (dysthymia) disorder)
    • Mood disturbance last more than 2 years with a depressed mood daily
  288. personal identity
    Knowing “who I am” formed through the numerous biologic, psychological, and social challenges and demands faced throughout the stages of life.
  289. pharmacogenomics
    Blends pharmacology with genetic knowledge; understanding and determining an individual’s specific CYP450 makeup and then individualizing medications to match the person’s CYP450 profile.
  290. phenotype
    Observable characteristics or expressions of a specific trait.
  291. phonic tics
    Tics that typically include repetitive throat clearing, grunting, or other noises but may also include more complex sounds, such as words; parts of words; and in a minority of patients, obscenities.
  292. phonologic processing
    Thought to be the cause of reading disability; a process that involves the discrimination and interpretation of speech sounds. Reading disability is believed to be caused by some disturbance in the development of the left hemisphere.
  293. phototherapy
    Also known as light therapy; involves exposing the patient to an artificial light source during winter months to relieve seasonal depression.
  294. physical well-being
    positive sleep patterns, healthy diet, or motivation to engage in healthy behaviors.
  295. pineal body
    Located in the epithalamus; contains secretory cells that emit the neurohormone melatonin (as well as other substances), which has been associated with sleep and emotional disorders and modulation of immune function.
  296. point prevalence
    • the basic measure that refers to the proportion of individuals in the population who have the disorder at a specified point in time (t). This point can be a day on the calendar, such as April 1, 2012, or a point defined in relation to the study assessment, such as the day of the interview. This is also expressed as a fraction:
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  297. polypharmacy
    Using more than one group from a class of medications at one time.
  298. population genetics
    The study of the inheritance of illness or traits from generation to generation.
  299. positive self-talk
    Countering fearful or negative thoughts by using preplanned and rehearsed positive coping statements.
  300. potency
    The dose of drug required to produce a specific effect.
  301. power of attorney
    As it relates to health care, an advanced care directive through which a proxy, usually a relative or trusted friend, is appointed to make health care decisions on behalf of an individual if that person is incapacitated.
  302. premenstrual dysphoric disorder
    Depressed mood following ovulation until a few days after menses
  303. prescribing information
    approved indications for the medication, side effects, adverse reactions, contraindications, and other important information.
  304. prevalence
    refers to the total number of people who have the disorder within a given population at a specified time regardless of how long ago the disorder started.
  305. privacy
    The part of an individual’s personal life that is not governed by society’s laws and governmental intrusion.
  306. proband
    A person who has a genetic disorder or a trait of a mental disorder.
  307. problem-focused coping
    A type of coping in which a person attacks the source of stress and solves the problem (eliminating it or changing its effects), which changes the person–environment relationship.
  308. process recording
    A verbatim transcript of a verbal interaction usually organized according to the nurse–patient interaction. It often includes analysis of the interaction.
  309. protective factors
    Characteristics that reduce the probability that a person will develop a mental health disorder or problem or decrease the severity of existing problems.
  310. protein binding
    The degree to which a drug binds to plasma proteins.
  311. pseudoparkinsonism
    Sometimes referred to as drug-induced parkinsonism; presents identically as Parkinson disease without the same destruction of dopaminergic cells.
  312. psychiatric rehabilitation programs
    Programs that are focused on reintegrating people with psychiatric disabilities back into the community through work, educational, and social avenues while also addressing their medical and residential needs.
  313. psychiatric–mental health registered nurse
    A registered nurse who demonstrates specialized competence and knowledge, skills, and abilities in caring for persons with mental health issues and problems and psychiatric disorders.
  314. psychoanalysis
    The Freudian treatment of choice; therapy focused on repairing the trauma of the original psychological injury through the process of accessing the unconscious conflicts that originate in childhood and then resolving the issues with a mature adult mind. Includes attempts to reconstruct the personality by examining free associations (spontaneous, uncensored verbalizations of whatever comes to mind) and the interpretation of dreams.
  315. psychoeducation
    An educational approach used to enhance knowledge and shape behavior by adapting teaching strategies to a patient’s disorder-related deficits.
  316. psychoeducational programs
    A form of mental health intervention in which basic coping skills for dealing with various stressors are taught.
  317. psychoneuroimmunology
    The study of relationships among the immune system, nervous system, and endocrine system and our behaviors, thoughts, and feelings.
  318. psychosis
    A category used by Freud and his followers to define those with severe mental illness that impaired daily functioning. Today, the term is used to describe a state in which the individual is experiencing hallucinations, delusions, or disorganized thoughts, speech, or behavior.
  319. public stigma
    Type of stigma that occurs after individuals are publicly “marked” as being mentally ill.
  320. rapport
    Interpersonal harmony characterized by understanding and respect that is established through interpersonal warmth, a nonjudgmental attitude, and a demonstration of understanding.
  321. rate
    • is the proportion of the cases in the population when compared with the total population. It is expressed as a fraction, in which the numerator is the number of cases and the denominator is the total number in the population, including the cases and noncases. The term average rate is used for measures that involve rates over specified time periods:
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  322. reappraisal
    Appraisal after coping that provides feedback about the outcomes and allows for continual adjustment to new information.
  323. receptors
    Proteins that receive released neurotransmitters. Each neurotransmitter has a specific receptor, or protein, for which it and only it will fit; serves a physiologic regulatory function.
  324. recovery centers
    assist in the mental health consumer’s journey toward recovery by offering self-help groups and training in daily living. In addition, recovery centers offer illness self-management interventions, such as Wellness Recovery Action Planning (WRAP). The WRAP intervention helps consumers develop individualized plans for achieving symptom stabilization and improved quality of life. The recovery center also provides informal social support, in which mental health consumers experience peer acceptance in a nonstigmatizing environment.
  325. referral
    Act of sending an individual from one clinician to another or from one service setting to another for care or consultation.
  326. reflection
    Continual self-evaluation through observing, monitoring, and judging nursing behaviors with the goal of providing ideal interventions.
  327. reframing
    a cognitive technique that can change the way a situation, event, or person is viewed and reduce the impact of anxiety-provoking thoughts. People with anxiety disorders often view themselves negatively and use “should statements” and “negative labels.” Should statements lead to rigid rules and unrealistic expectations. By encouraging patients to avoid the use of should statements and reframe their views, they can change their beliefs to be more realistic. For example, if a patient says, “I should be a better parent” or “I’m a useless failure,” the nurse could ask the person to identify the positive aspects of parenting and other successes.
  328. reintegration
    A term used to describe the process of the return and acceptance of a person as a fully participating member of a community through work, educational, and social avenues.
  329. relapse
    Recurrence or marked increase in severity of the symptoms of the disease, especially after a period of apparent improvement or stability; the recurrence of alcohol- or drug-dependent behavior in an individual who has previously achieved and maintained abstinence for a significant time beyond the period of detoxification.
  330. relational aggression
    A type of bullying, more commonly used by girls, that involves disrupting peer relationships by excluding or manipulating others and spreading rumors.
  331. relationship questions
    Questions used to amplify and reinforce positive responses to the other questions.
  332. relaxation techniques
    used as mental health interventions range from simple deep breathing to biofeedback to hypnosis. Although some techniques, such as biofeedback, require additional training and, in some instances, certification, nurses can easily apply simple relaxation, distraction, and imagery techniques.
  333. religiousness
    The participation in a community of people who gather around common ways of worshiping.
  334. reminiscence
    Thinking about or relating past experiences.
  335. repetitive transcranial magnetic stimulation
    Noninvasive, painless method to stimulate the cerebral cortex, which activates inhibitory and excitatory neurons.
  336. residential services
    A place for people to reside during a 24-hour period or any portion of the day on an ongoing basis.
  337. resilience
    Ability to recover readily from illness, depression, adversity, or the like. The ability to recover or adjust to challenges over time. Attaining good mental health despite the presence of risk factors and genetic predisposition.
  338. resolution phase
    The termination phase of the nurse–patient relationship that lasts from the time the problems are resolved to the close of the relationship. Also, in regards the human sexual response cycle, the gradual return of the organs and body systems to the unaroused state.
  339. restoration-oriented coping
    Part of the dual process model of bereavement during which the bereaved person is preoccupied with stressful events as a result of the death (financial issues, new identity as a widow[er]).
  340. restraint
    The use of any manual, physical, or mechanical device or material that when attached to the patient’s body (usually to the arms and legs) restricts the patient’s movements.
  341. risk factors
    Characteristics, conditions, situations, or events that increase the patient’s vulnerability to threats to safety or well-being.
  342. sandwich generation
    People with caregiving responsibilities toward the elder generation above and two generations of children below them.
  343. scaling questions
    Questions that quantify exceptions noted in intensity and in tracking change over time using a scale of 1 to 10.
  344. schema
    A cognitive structure, or an individual’s life rules, that act as a filter that screens, codes, and evaluates the incoming stimuli through which the individual interprets events.
  345. scope and standards of practice
    • Six standards of practice are organized according to the nursing process and include
    • assessment,
    • diagnosis,
    • outcome identification,
    • planning,
    • implementation, and
    • evaluation
  346. seclusion
    Solitary confinement in a full protective environment for the purpose of safety or behavior management.
  347. sedative–hypnotics
    Medications that induce sleep and reduce anxiety.
  348. sedatives
    Medications that reduce activity, nervousness, irritability, and excitability without causing sleep, but if given in large enough doses, they have an hypnotic effect.
  349. selectivity
    The ability of a drug to be specific for a particular receptor, interacting only with specific receptors in the areas of the body where the receptors occur and therefore not affecting tissues and organs where these receptors do not occur.
  350. self-care
    The ability to perform activities of daily living (ADLs) successfully.
  351. self-concept
    The sum of beliefs about oneself, which develops over time. Includes three interrelated dimensions: body image, self-esteem, and personal identity.
  352. self-disclosure
    The act of revealing personal information about oneself.
  353. self-efficacy
    Self-effectiveness; a person’s belief in his or her own abilities.
  354. self-esteem
    Attitude about oneself. Healthy self-esteem includes feelings of self-acceptance, self-worth, self-love, and self-nurturing.
  355. self-stigma
    Type of stigma that occurs when negative stereotypes are internalized by people with mental illness.
  356. self-system
    An important concept in Peplau model. Drawing from Sullivan, Peplau defined the self as an “antianxiety system” and a product of socialization.
  357. separation anxiety disorder
    Developmentally inappropriate fear and anxiety around separation from home or attachment figure.
  358. serotonin
    Also called 5-hydroxytryptamine or 5-HT, this is primarily an excitatory neurotransmitter that is diffusely distributed within the cerebral cortex, limbic system, and basal ganglia of the central nervous system. Serotonergic neurons also project into the hypothalamus and cerebellum. Plays a role in emotions, cognition, sensory perceptions, and essential biologic functions (e.g., sleep and appetite).
  359. serotonin syndrome
    A potentially life-threatening side effect that occurs as a result of an overactivity of serotonin or an impairment of the serotonin metabolism. Symptoms include mental status changes (hallucinations, agitation, and coma), autonomic instability (tachycardia, hyperthermia, changes in blood pressure), neuromuscular problems (hyperreflexia, incoordination), and gastrointestinal disturbance (nausea, vomiting, diarrhea).
  360. sibling position
    The relative social status of the children in the family based on birth order.
  361. side effects
    Unintended effects of medications.
  362. situational crisis
    A crisis that occurs whenever a specific stressful event threatens a person’s biopsychosocial integrity and results in some degree of psychological disequilibrium.
  363. social anxiety disorder
    Fearful, anxious or avoids social situations that involve possibility of being scrutinized
  364. social distance
    Degree to which the values of a formal organization and its primary group members differ.
  365. social functioning
    Performance of daily activities within the context of interpersonal relations and family and community roles.
  366. social network
    Linkages among a defined set of people, among whom there are personal contacts.
  367. social skills training
    A psychoeducational approach that involves instruction, feedback, support, and practice with learning behaviors that help people interact more effectively with peers and children and with adults.
  368. social support
    Positive and harmonious interpersonal interactions that occur within social relationships.
  369. social well-being
    involves developing a sense of connection and a well-developed support system. The social systems to examine include the family, the culture to which the patient belongs, and the community in which he or she lives.
  370. solubility
    Ability of a drug to dissolve.
  371. specific phobia disorder
    marked by persistent fear of clearly discernible, circumscribed objects or situations, which often leads to avoidance behaviors. Phobic objects can include animals (e.g., spiders, snakes), natural environment (e.g., heights, storms), blood injection injury (e.g., fear of blood, injections), and situational (e.g., elevators, enclosed spaces). The lifetime prevalence rates range from 7% to 9%, and the disorder generally affects women twice as much as men. It has a bimodal distribution, peaking in childhood and then again in the 20s. The focus of the fear in specific phobia may result from the anticipation of being harmed by the phobic object. For example, dogs are feared because of the chance of being bitten or automobiles are feared because of the potential of crashing. The focus of fear may likewise be associated with concerns about losing control, panicking, or fainting on exposure to the phobic object.
  372. spiritual support
    Assisting patients to feel balance and connection within their relationships; involves listening to expressions of loneliness, using empathy, and providing patients with desired spiritual articles.
  373. spirituality
    Beliefs and values related to hope and meaning in life.
  374. steady state
    Absorption equals excretion and the therapeutic level plateaus.
  375. stress response
    Physiologic, behavioral, and cognitive reaction to an appraised threatening person–environment event.
  376. structural imaging
    The aspect of neuroimaging that visualizes the structure of brain and allows diagnosis of gross intracranial disease and injury.
  377. structured interaction
    Purposeful interaction that allows patients to interact with others in a useful way.
  378. substrate
    The drug or compound that is identified as a target of an enzyme.
  379. subsystems
    A systems term used by family theorists to describe subgroups of family members who join together for various activities.
  380. suicidal ideation
    Thinking about and planning one’s own death without actually engaging in self-harm.
  381. suicidality
    All suicide-related behaviors and thoughts of completing or attempting suicide and suicide ideation.
  382. suicide attempt
    A nonfatal, self-inflicted destructive act with explicit or implicit intent to die.
  383. suicide contagion
    Suicide behavior that occurs after the suicide death of a known other (i.e., a friend, acquaintance, or idolized celebrity). Also called cluster suicide.
  384. symbolism
    The use of a word or a phrase to represent an object, event, or feeling.
  385. synaptic cleft
    A junction between one nerve and another; the space where the electrical intracellular signal becomes a chemical extracellular signal.
  386. syndrome
    A set of symptoms that cluster together that may have multiple causes and may represent several different disease states that have not yet been defined.
  387. systematic desensitization
    A method used to desensitize patients to anxiety-provoking situations by exposing the patient to a hierarchy of feared situations. Patients are taught to use muscle relaxation as levels of anxiety increase through multisituational exposure.
  388. tardive dyskinesia
    A late-appearing extrapyramidal side effect of antipsychotic medication that involves irregular, repetitive involuntary movements of the mouth, face, and tongue, including chewing, tongue protrusion, lip smacking, puckering of the lips, and rapid eye blinking. Abnormal finger movements are common as well.
  389. target symptoms
    Specific measurable symptoms expected to improve with treatment for which psychiatric medications are prescribed. Examples include hallucinations, delusions, paranoia, agitation, assaultive behavior, bizarre ideation, social withdrawal, disorientation, catatonia, blunted affect, thought blocking, insomnia, and anorexia.
  390. task roles
    The group role of an individual that is concerned about the purpose of the group and keeps the focus on the task of the group.
  391. therapeutic foster care
    The placement of patients in residences of families specially trained to handle individuals with mental illnesses. Indicated for patients in need of a family-like environment and a high level of support.
  392. therapeutic index
    A ratio of the maximum nontoxic dose to the minimum effective dose.
  393. token economy
    The application of behavior modification techniques to multiple behaviors. In a token economy, patients are rewarded with tokens for selected desired behaviors that they can then redeem for special privilege or similar.
  394. tolerance
    A gradual decrease in the action of a drug at a given dose or concentration in the blood. The ability to ingest an increasing amount of alcohol before a “high” and cognitive and motor effects are experienced.
  395. Tourette disorder
    The most severe tic disorder. Defined by multiple motor and phonic tics for at least 1 year.
  396. toxicity
    The point at which concentrations of a drug in the bloodstream become harmful or poisonous to the body.
  397. transaction
    Transfer of value between two or more individuals.
  398. transfer
    The formal shifting of responsibility for the care of an individual from one clinician to another or from one care unit to another.
  399. transference
    The unconscious assignment to a therapist or nurse of a patient’s feelings and attitudes that were originally associated with important figures such as parents or siblings.
  400. transition times
    Times of addition, subtraction, or change in status of family members.
  401. transitional care
    used in the community to ensure that people with mental illnesses stay engaged in treatment between discharge from the hospital and the first follow-up appointment. For example, medication management coordinators meet with patients following discharge from the hospital to assess clinical status and provide medication education, they can also foster communication between settings by ensuring that all inpatient and outpatient providers receive information about a patient’s complete medication history. The use of peer support personnel is also an effective strategy to help people with serious mental illnesses navigate the transition between the inpatient and outpatient settings. They can help patients make medical appointments, communicate with health care providers, and encourage adherence to medical treatment. When patients with serious mental illnesses have medical comorbidities, transitional care teams may provide self-management education for patients and families, use a care manager to ensure service coordination and medication reconciliation, and ensure that primary care follow-up occurs soon after discharge from the hospital.
  402. trauma-informed care
    being aware of and sensitive to doing no further harm to survivors of trauma, is important in recovery-oriented practice. There is general agreement that in order to use a trauma-informed approach, the patient needs to feel connected, valued, informed, and hopeful of recovery, the staff recognize the connection between earlier trauma and adult mental health problems, and staff work in mindful and empowering ways with individuals and families.
  403. traumatic crisis
    A crisis initiated by unexpected, unusual events in which people face overwhelming hazards that entail injury, trauma, destruction, or sacrifice. May affect an individual or a multitude of people at once.
  404. triad
    A group consisting of three people.
  405. triangles
    A three-person system and the smallest stable unit in human relations.
  406. uncomplicated bereavement
    uncomplicated grief Grief that is painful and disruptive within normal expectations after the loss of a loved one.
  407. unconditional positive regard
    A nonjudgmental caring for a client.
  408. uptake receptors
    (carrier protein) A membrane protein that transports a specific molecule across the cell membrane.
  409. validation
    A process that affirms patient individuality and reflects the staff member respect for a patient in any interaction.
  410. veracity
    The duty to tell the truth.
  411. verbal communication
    The use of the spoken word, including its underlying emotion, context, and connotation.
  412. volitional factors
    Integrated Motivational Volitional (IMV) model proposes that motivational factors such as defeat and entrapment cause the suicide ideation. The progression from suicide ideation to suicide attempt is explained by volitional factors such as acquired capability, access to lethal means, planning, and impulsivity. In one study, suicide attempters (n = 230) differed from suicide ideators in all volitional factors. In addition, attempters were likely to have a family member and close friend who had been self-injured or attempted suicide
  413. voluntary admission
    • (voluntary commitment)
    • The legal status of a patient who has consented to being admitted to the hospital for treatment, during which time he or she maintains all civil rights and is free to leave at any time even if it is against medical advice.
  414. vulnerable child syndrome
    A phenomenon that occurs when family members view a child as sick despite current good health and as a result are overprotective of the child.
  415. working memory
    An important aspect of the brain’s frontal lobe function, including the ability to plan and initiate activity with future goals in mind.
  416. working phase
    The second phase of the nurse–patient relationship in which patients can examine specific problems and learn new ways of approaching them.
  417. young-old
    A term used to describe adults ages 65 to 74 years.
  418. Zeitgebers
    Specific events that function as time givers or synchronizers and that result in the setting of biologic rhythms.
Author
Pandora320
ID
343207
Card Set
Exam 2 - Mental Health
Description
Exam 2 terms from chapters 1-21, 23, 25, 36 in Boyd
Updated