quiz 2

• Mild: special attention, increased sensory stimulation, motivational, helps someone grow, learn and change
• Moderate: something definitely wrong, nervousness/agitation, difficulty concentrating, able to be redirected, learning is still possible
• Severe: trouble thinking, tightened muscles, increased vital signs, restless, irritable, angry
• Panic: fight, flight, or freeze response, increased vital signs, dilated pupils

• turning negative messages into positive ones
• (cognitive behavior therapy)

• Making more realistic appraisal of a situation
• (cognitive behavior therapy)

• learn to negotiate interpersonal situations
• (cognitive behavior therapy)

• Discrete episodes of panic with no stimulus/reason
• Avoidance behavior
• Primary, secondary gain (sick role is an added benefit for a physical complaint)

• CBT
• deep breathing
• relaxation
• benzos
• SSRIs
• TCAs
• antihypertensives (clonidine, propanolol)

cognitive behavioral therapy

• Intense illogical persistent fear
• Includes agoraphobia, specific phobia, social phobia

• behavioral therapy
• positive reframing
• assertiveness traning
• systematic desensitization
• flooding
• antidepressants
• anxiolytics

recurrent, persistent, intrustive, unwanted throughts, images, impulses, causing marked anxiety

ritualistic or repetitive behaviors or mental acts carried out continuously to neutralize anxiety

• medications (table 13.3)
• behavior therapy (exposure, response prevention)

(don't stop a ritual unless it's harmful to the patient -> decreases trauma)

• Chronic - longer than 6 months
• Treat with Buspirone (BuSpar) and SSRIs

• re-experiencing traumatic event
• flashbacks

• more dissociative response than PTSD
• emotional detachment
• muddled obliviousness to environment

• An individual's inability to solve a problem, usual coping mechanisms cannot resolve the problem
• Acute event

• 1. Initial threat
• 2. Continuing threat becomes a crisis
• 3. Crisis intensifies to panic
• 4. Serious disorganization and assault

If an individual is able to constructively solve a crisis, the individual will gain greater personality integration and coping abilities, failure to do so results in disorganization.

the person's perception of the event.

need more of the substance to get the same effect

• After developing a tolerance, the tolerance is dramatically lowered temporarily
• Person can overdose easily at this time

• CNS depressant -> relaxation/loss of inhibitions
• use: vomiting, unconsciousness
• overdose: respiratory rate depressed
• withdrawal: 4-12 hours after cessation, peak on the second day, lasts about 5 days. Use benzodiazepines (Valium) for safe withdrawal

• 1. Denial
• 2. Anger
• 3. Bargaining
• 4. Depression
• 5. Acceptance

Grief over a loss that is not or cannot be acknowledged openly, mourned publicly, or supported socially.

Grief that is outside the norm; person may be void of emotion, grieve for prolonged periods, or has ezpressions of grief that seem disproportionate to the event.

• Pervasive alterations in emotions that are manifested by depression, mania, or both
• Interfere with individual's life
• Alteration in mood, not thought

• SSRIs
• TCAs
• MAOIs
• SNRIs
• NDRI
• EMSAM (patch version of MAOIs w/o dietary restrictions)

• GI distress
• low anticholinergic
• low sedation
• sexual disfunction
• orthostatic hypotension (VITALS)

• weight gain
• dry mouth
• constipation
• sedation, drowsiness
• hypotension (VITALS)
• blurred vision
• urinary retention
• sinus tachycardia
• decreased memory

• occurs from taking a SSRI and MAOI
• change in mental status (confusion and agitation)
• fever, shivering, sweating
• rigidity, jerks (myoclonus), collapse, paralysis, weakness
• sluggish pupils
• tachycardia/pnea, hypersalivation
• treatment: discontinue use, provide supportive treatment, notify physician

• potentially lethal reaction to dopamine blocking/antipsychcotic drugs, usally occus in first 2 weeks of therapy
• rigidity
• high fever
• unstable BP
• diaphoresis
• pallor
• elevated enzymes, especially creatine phosphokinase; leukocytosis
• changes in mental status; delirium
• treatment: discontinue use, treat adverse symptoms

direct or indirect suicidal thoughts

direct verbal or written messages of intent

• actions resulting in minor injury
• no intention to die

serious actions with intention to die

death of a person who had conscious intent to die

• Block reuptake of norepinephrine and serotonin
• SSRIs have fewest side effects (common ones are dizziness, drowsiness, and dry mouth)
• TCAs and MAOIs take a while to kick in

• lithium (serum lithium maintenance level is 0.5 - 1.5 mEq/L)
• anticonvulsants raise brain's stimulus threshold

The use of a substance that results in maladaptive behavior.

The negative psychologic and physical reactions that occur when use of a substance ceases or dramatically decreases

The process of safely withdrawing from a substance

Using a drug in a way that is inconsistent with medical or social norms and despite negative consequences

Problems with addiction like tolerance, withdrawal, and unsuccessful attempts to quit

• Abuse: creates problems in social, vocational, or legal areas of a person's life
• Dependence: creates physical problems like tolerance, withdrawal, and unsuccessful attempts to quit

• N/V
• tremors
• sweating
• anxiety
• agitation
• tactile/auditory/visual disturbances
• elevated pulse and BP
• insomnia
• HA
• disorientation

use benzos for safe withdrawal

• alcohol
• benzos
• sedatives

• Clonadine
• (assess BP!)

• precontemplation
• contemplation
• determination/preparation
• action, maintenance
• relapse/recycle

give vitamin B1, or thyamine (banana bag)

• euphoria
• hyperactivity
• hypervigilance
• talkativeness
• anxiety, anger
• hallucinations, grandiosity
• stereotypic/repetitive behavior
• impaired jugment
• tachycardia
• HTN
• dilated pupils

• dysphoria
• fatigue
• vivid/unpleasant dreams
• insomnia/hypersomnia
• increased appetite
• psychomotor retardation

• drug prescribed to create an adverse reaction while drinking:
• flushing
• throbbing HA
• sweating
• n/v
• HTN
• confusion
• coma/death

The return to drug use after a drug-free period

A way of dealing with behavior that damages the health of the person involved and of their community. Goal is abstinence, but it can help reduce drug use and drug-related deaths, disease, and crime.

• ex. Offering education and referral to drug treatment opportunities.
• Permitting drug users to exchange used syringes for new ones, or buy new syringes.