Study guide Test 1 (psychology)

1.1 Self-awareness & the communication process in psychiatric-mental health nursing

1.1 describe how genuineness, empathy and positive regard facilitate the therapeutic alliance
Genuineness- remaining focused on the p/t and responding with sincere interest. Consistent with both verbal
and nonverbal behavior. Necessary for p/t's to develop trust in the nurse.
Empathy (objective)- the nurse is genuinely aware of the p/t's emotions. Ability to perceive the p/t's world
from their perspective and ability to communicate this understanding to the p/t.
Positive regard-includes respect (viewing the other as worthy, physically and emotionally present to the p/t's
needs and feelings) and acceptance (nonjudgmental).
Together these skills or characteristics allow a therapeutic alliance to exist. Therapeutic alliance is guided by standards
and objectives which allows p/t's to accomplish the following:
1. freely discussing their needs and problems in the absence of judgment and criticism.
2. Gaining insight into their problems, expectations, abilities, and support systems.
3. Learning and practicing new skills
4. effecting life changes
5. healing mental and emotional wounds
6. promoting growth
1.2 Describe the difference between a therapeutic nurse-patient relationship and intimate or social relationship.
Therapeutic nurse-p/t relationship:
helps p/t solve problems, make decisions, achieve growth, learn coping strategies, let go of unwanted
behaviors, reinforce self-worth, and examine current relationships.
No mutual satisfaction- Nurse is not p/t's friend-healthy boundaries are to be maintained
Objective- remaining free of bias, prejudice, and personal identification during interactions w/ p/t. Fosters
independence and p/t believes you understand him/her.
p/t centered- resistance: when p/t changes subject to nurse or other things. Redirect back to p/t.
Purposeful & Goal directed
Time limited
Do not keep secrets! explain to p/t that you have to tell about the secret so he/she can be helped.
Social relationship:
give & receive friendship equally
meet both individuals' needs
share mutual ideas & experiences
give personal opinions & advice
subjective- based on the nurse's own feelings & beliefs. Keep it p/t focused not you focused
open ended
1.3 Discuss the importance of boundaries in the therapeutic relationship.
Define the nurses role. Trying to be a p/t's friend blurs boundaries & confuses roles. The nurse helps p/t to
increase their awareness & knowledge of the presence or absence of their own boundaries, as well as
understanding the purposes that others have for maintaining boundaries.
1.4 Identify stages of the nurse-p/t relationship.
Pre-orientation- gather data from all available sources about the p/t. Autodiagnosis is when nurse addresses
his/her thoughts, feelings, perceptions, and attitudes about this particular p/t.
Orientation- introductions. build trust and rapport. Contract agreement is established. Assess & begin a plan
of care.
Working- p/t takes responsibility and actively engages in his/her own plan of care. Facilitate behavioral
change, explore feelings & thoughts. Until the p/t ACTUALLY PARTICIPATES in making changes, the
working stage is not reached. Safety & health problems are a main priority above all others.

Termination- relationship ends. Termination actually begins during the orientation phase, when the nurse first
sets meeting times (lets p/t know that it will eventually end). Summarize & don't initiate new topics unless
p/t shows signs that treatment is still needed.

1.5 Discuss the importance of self-awareness

Developing a clear understanding and awareness of self allows the nurse to respect and avoid projecting his/her own
beliefs onto others. Nurse is able to suspend judgment and focus on the needs of the client, even of they differ from
those of the nurse.
1.6 Identify factors that influence communication.
Environmental- time, location, noise, privacy, comfort, and temperature.
Relationship b/t the sender & the receiver- receiver may react differently to each person according to the
nature of each relationship.
Context & content of the message- appropriate to type of interaction.
Perception- sender needs to be certain that the receiver has a clear understanding of the message
knowledge differences
Attitude
1.7 Discuss differences b/t verbal & nonverbal methods of communication
Verbal
spoken words mean different things to different people.
figures of speech, jokes, cliches, colloquialisms, and other terms or special phrases carry a variety of
meanings. Can be interpreted literally by a p/t w/ schizophrenia or P/t w/ psychosis who has loose
associations.
Develop a sensitivity to the cultural aspects of communication.
Non-verbal
most important and involve the 5 senses.
Expression of feelings, contradiction/validation of verbal messages, preservation of both the ego & the
relationship.
More revealing & truthful than verbal communication
nonverbal cues need to be congruent with verbal messages
facial expressions; eye movements; body movement such as posture, gestures, & touch; appearance; and use
of space (proxemics).
1.8 Discuss the behaviors of self-disclosure, touch, humor, and resistance & their impact on communication.
Self-disclosure- opening oneself to another. Effective therapeutic skill if it fully understood and used
carefully. Self-disclosure is for the p/t's benefit and never for the nurse's. Acceptable when you want to
educate, facilitate the therapeutic relationship, provide concrete reflection that encourages reality testing. Ex.
Refer to Box 4-2 pg. 75.
Touch- Powerful nonverbal method that expresses many messages. Age, gender, interpretation of the gesture,
cultural background, and appropriateness of the touch all influence reactions to touch.
Humor-useful & powerful when used in a planned way for a specific therapeutic intent. Depressed p/ts have
missing outward expression of laughter. P/ts w/ paranoid features are unable to laugh and usually view others'
laughter as a personal attack. Humor is non-therapeutic when is used constantly; when rapport has not been
established; or when a p/t is very ill, fearful, anxious, having a high level of pain, or very depressed.
Resistance- p/ts consciously or unconsciously maintain a lack of awareness of their problems to avoid
anxiety. Nurse should assure and remind the p/t of progress they made in order to build p/t's confidence and
offer hope that will counteract resistance.
1.9 Identify therapeutic & ineffective responses (Table 4-4 pg 78)
Ineffective responses include:
offering false reassurances- don't worry everything will be fine
Not listening

offering advice
belittling
disagreeing
probing
challenging
minimizing the problem- that's nothing compared to other p/ts problems
judging
Effective responses include:
Silence-gives p/ts time to feel comfortable & respond when they are ready
Active listening- paraphrasing the p/ts thoughts & feelings, asking Qs
support & reassurance
providing information
open-ended statements
transference- unconscious association of person w/ another person in their life
displacement- transfers feelings & attitudes about another person to the nurse.
Nursing response- listen & then use TC to clarify, reflect & problem solve
Counter transference- nurses unconscious emotional response to the p/t that is irrational, highly emotionally
charged & does not match the situation or interactions
use self-appraisal to identify source of CT. seek outside help if necessary
gain a better understanding of the p/t's background & refocus on the p/t
be aware of your + & - response to the p/t
don't let CT get in the way

1.10 Identify culturally-competent behaviors to facilitate communication.

Nurses must value & adapt to diversity, conduct self-assessments, manage differences, and obtain cultural
knowledge & incorporate it into their clinical practices.
Attitude of humility ( apologize for not speaking the p/t's native language) , respecting & allowing for a free
exchange of the p/t's & family's ideas, thoughts, and feelings; providing an interpreter; avoid stereotyping.

1.2 Intro to PMH nursing & the nursing process

1.1 Identify 4 major objectives that guide the practice of nursing in psychiatric settings.
1. Promotion & protection of mental health: educating/increasing awareness of mental health & mental
disorders; ensuring access to health car; encouraging & providing support for individuals, families etc.;
mentoring; reducing the stigma associated w/ mental disorders.
2. Prevention of mental disorders:
Primary prevention- helps reduce the incidence (occurrence) of mental disorders. Promoting awareness,
providing information, offering stress-reduction techniques/mindful meditation.
Secondary prevention- reduce the prevalence (existing # at a given time) of mental disorders. Early
identification & treatment.
Tertiary prevention- reduce the residual effects & promote rehabilitation and restoration.
3. Treatment of mental disorders- P/ts are encouraged to make decisions & to actively engage in their own treatment
plans to meet their needs. P/t centered; DeInstitutionalized (mental institutions closed, shift to community treatment);
evidence based practice; integrated healthcare (dualism- address the physical & mental aspects there is much
physical in the mental and much mental in the physical).
4. Recovery and rehabilitation:
-Return to the pre-illness level of function
-Aim for independence
- Engage in the meaningful activities (work) & social activities
- support resilience- ability to bounce back after stressful situations or events
1.2 Describe how the psychiatric mental health nursing specialty is relevant to the practice of nursing in all clinical
settings.
-Research shows that many p/ts treated in non-psychiatric inpatient & outpatient settings have at least on

concomitant diagnosis of mental illness.

1.3 Differentiate b/t mental health & mental disorder/illness
Mental health- mentally healthy people are thought to be in balance or harmony w/ their environment & share
similar traits. Intact anatomy & physiology of the brain & CNS; Thinks clearly; attains & maintains positive
self-system: appreciates life; is autonomous; separates fantasy from reality.
Mental illness/disorder- Mental disorder is a significant behavioral or psychological pattern associated w/
distress or disability that greatly deviates from the norm. Identified by the p/t's responses to the disorder &
classified based on certain indicators that meet defined criteria for a specific psychiatric diagnosis. Not all
metal, emotional, or behavioral disturbance are mental disorders.
-Mild-moderate: psychophysiological factors effecting medical conditions
-Moderate-severe: Anxiety, dissociative, somatoform, personality, and eating disorders.
-Severe-psychosis: Depressive, bipolar, schizophrenic, cognitive disorders.
1.4 Describe psychiatric-mental nursing (including the list up to 1.47)
Levels of prevention- mentioned previously.
Levels of practice- basic (RN-PMH requires a bachelors degree) advanced levels (APRN-PMH requires a
master's or doctoral degree)
Standards of practice- Refer to inside back cover of book
settings for practice- Mental health hospital/unit, Emergency department, ICU, Med-surg, correctional facility
& community center, home & school, homeless shelter or private practice.
Cultural influences as an obstacle for treatment of the mentally ill- cultural heritage, ethnicity, religion,
environment, language, and culture is an integral part of all lived experiences.
Managed care environments & the effect on treatment- in an effort to control the rising costs w/ psychiatric
treatment, many insurance plans carve out the management of mental health benefits to managed behavioral
health organizations. Nurse & physicians need to consider their legal & ethical responsibilities for defending
the p.t when managing care either pressuring to limit or deny p/t access to treatment.
Stigma as an obstacle for the mentally ill- p/ts w/ chronic mental disorders often suffer deeply from stigma,
which in this respect is defined by a mark of disgrace or shame of mental illness. They receive labels, and
they become victims of bias & negative stereotypes.
1.5 Describe the DSM-IV-TR & multi-axial system of diagnosing the mentally ill p/ts (check appendix in evolve
website to view this)
In the medical model of psychiatry, health problems are the mental disorders in the diagnostic & statistical
manual of mental disorders (DSM).
Identifies clinically significant behavior
behavior is associated w/ distress or disability
provides specific criteria for medical diagnosis
cultural differences can lead to misdiagnosis
Consists of 5 parts or axes according to the current DSM, 4th edition (DSM-IV-TR), presently 5th edition:
-Axis I: psychiatric diagnosis
-Axis II: personality disorder or mental retardation
-Axis III: medical diagnosis
-Axis IV: psychosocial & environmental stressors
Problems with: 1. family/support group 2. r/t to social environment 3.educational, 4. occupational 5. housing 6.
economic 7. Access to health care 8. legal system 9. other psychosocial & environmental
-Axis V: global assessment of functioning (91-100 measures p/ts overall level of psychological, social,
and occupational functioning on a hypothetical continuum)
1-30 inpatient care may be required
31-60 outpatient treatment may be required
61-100 usually treatment not required
(p/ts w/ severe & persistent mental illness have low GAF scores)

1.6 Relate Orem's Self-Care Deficit Theory to the care of the mental health p/t
The primary focus of the PMH nurse is to assist the p/t to cope w/ or overcome self-care deficits that are
emotionally r/t.
Wholly compensatory- a p/t's self-care agency is so limited that he/she depends on others well-being.
Partially compensatory- a p/t can meet some self-care requisites but needs nurse to help meet others.
Supportive/educative- a p/t can meet self-care requisites but needs help in decision making, behavior control,
or knowledge acquisition.
1.7 Identify the components of a psychosocial assessment & the mental status examination .
Mental status examination

Mental health originates in a person's biology, then is demonstrated in various perceptions, thoughts,
emotions, & behaviors. Determined through evaluation of a person's emotional, perceptual, cognitive &
behavioral status.
Appearance-dress/grooming
behavior/activity- hypo/hyperactivity, relaxed/restlessness/gait
attitude- cooperative, resistive, hostile
speech- quality, quantity, rate
mood- sad, angry , depressed
affect- apathetic, flat, euphoric, bizarre
perceptions- hallucinations, distortions
thoughts- logical vs illogical, obsessions, delusions, abstract vs concrete
sensory & cognition- orientation to person, place, time and situation. Attention span, memory, intelligence
judgment-assess & evaluate situations, make rational decisions
insight- ability to perceive & understand the cause in nature of own & others situations
reliability- interviews impressions whether reported info is accurate & complete.

Psychosocial Assessment

stressors- internal & external

coping skills- the ability to adapt to internal & external stressors
relationships- attainment & maintenance of satisfying interpersonal relationships
cultural-ability to adapt & conform to prescribed norms/ethics of an identified group
spiritual- presence of a self satisfying value belief system that individuals regard as right/comforting.

1.8 Identify nursing diagnosis used in the care of p/ts in the psychiatric setting.
Ineffective coping (use cautiously)
disturbed thought process
risk for suicide
dysfunctional grieving
hopelessness
chronic low self-esteem
focus on the disturbed thoughts & sensory perceptions that result from delusions & hallucinations rather than
attempting to treat the disorder.

1.3 Legal And Ethical Aspects

1.1 Describe various standards for psychiatric-mental health nursing.
Standards of care:
Standard 1: Assessment
Standard 2: Diagnosis

 Standard 3: outcome Identification

Standard 4: Planning
Standard 5: Implementation
Standard 6: Evaluation
ANA standards of Care Psychiatric-Mental Health Nursing:
Counseling
Milieu Therapy
Promotion of Self-Care Activities
Case Management
Health Promotion & Health Maintenance
Standards of Professional Performance
Standard 1: Quality of Care
Standard 2: Performance Appraisal
Standard 3: Education
Standard 4: Collegiality
Standard 5: Ethics
Standard 6: Collaboration
Standard 7: Research
Standard 8: Resource Utilization
Standard 9: Leadership
1.2 Describe psychiatric mental hospital admissions, commitment and discharge procedures.

Voluntary Commitment: P/ts enter voluntarily by consenting to be admitted & treated. If they seek a
discharge from the hospital but are in immediate danger to themselves or others they may be placed on an
emergency commitment status pending further evaluation & treatment.
Emergency Commitment: When the effects of the p/ts mental illness result in an immediate risk for self-harm
or harm of others. In some states, if the effect of the mental illness is such that the p/t is unable to provide
food, clothing or shelter for himself/herself.
-Short period/ restrictive criteria for admission.
-Physician, psychologist, social worker or advance practice nurse must see the individuals
-After the individual is brought to the inpatient unit, a second mental health professional, usually a
psychiatrist, has to make an examination.
-within 5 days or less, a probable cause hearing has to take place to continue the person's hospitalization.
Civil or Judicial Commitment: longer amount of time than an emergency commitment. Lies in the states
power to protect & care for individuals w/ disabilities & the police power to protect the community.
Individual has the right to attorney & trial by jury. Utilized to mandate inpatient or outpatient treatment.
P/t who are ruled competent & who are voluntarily or involuntarily committed have the right to refuse
treatment & medication. During emergency situations if there is potential danger, p/ts can be forcibly
medicated.
Patient must sign a Written Intent To Terminate Treatment if they want to leave the hospital AMA. The
hospital must discharge within 3 days unless the hospital determines the patient may be a risk to self or other
and has petitioned the court for an involuntary commitment.

1.3 Describe the legal & ethical considerations in maintaining p/t confidentiality
HIPAA Law:
Guarantees the security & privacy of p/t health information; outlines standards of performance; &
consequences of violation of act.
Covers verbal, written & electronic information
protected informationAny individually identifiable health information that an organization keeps, files,
uses of shares

P/t treated for mental health & substance use disorders have more restrictions in act
release of information signed by p/t is required to share information
the confidentiality of the p/t's information & the necessity of having a signed release from the p/t before
releasing informationeven when family members who are closely involved w/ the p/t's daily carepresent
challenges for the nurse.

1.4- 1.43 Describe common liability issues applicable to the psychiatric-mental health setting
Duty to warn/duty to protect (tarasoff)- protective privilege ends where the public peril begins established
the responsibility of a treating mental health professional to notify an intended and identifiable victim.
Seclusion & restraints- only used when less restrictive alternatives to ensure p/t safety had failed, such as
talking to the p/t. Coercion, discipline, punishment, and staff convenience are never acceptable reasons for
placing a person in S/R. Within 1 hr a face to face assessment is required even if the p/t has been released
from restraints before the arrival of the LIP. P/t's family and legal representatives are to be notified when
restraints are used. Continuous in-person observation (15-min checks) of any p/t restraints for the duration for
the restraint procedure.
Mal-practice/Negligence- A health professional omits or commits an act that a reasonable prudent
professional would not do.
Non-intentional-negligence (primary basis for most mal-practice lawsuits in the USA)
Lawsuits must establish that the nurse had a legal duty or relationship to provide a certain standard of
care to a client. Did the nurse cause this to occur?
Protect yourself by documenting & keeping detailed records
1.5-1.55 Describe the client's rights in the psychiatric mental health setting.
Right to treatment-cannot keep in a psychiatric hospital if not providing treatment.
Right to refuse treatment- in MI an involuntary committed p/t cannot refuse medication or treatment, but
he/she can question treatment & participate in his/her treatment planning process.
ECT- remains controversial, an effective therapy for resistant & life threatening depression, requires informed
consent, requires 2 psychiatric evaluations (MI), issues pertaining to informed consent, potential side effect is
memory loss that is usually temporary but is sometimes irreversible.
Research- client must be thoroughly informed about the purpose, risks, benefits, alternatives, etc before
agreeing to be in research or trial treatments/projects. Requires informed consent.
Psychiatric advanced directives- a legal document is created when the person is able to make decisions, and
that is utilized only when the p/t is unable to participate in their own decision making. Surrogate decision
maker is a p/t advocate who carries out the p/ts wishes or makes decisions about his/her care, but only when
the p/t is so ill or injured that he/she cannot make his/her own treatment decisions.
1.6-1.64 Describe aspects of documentation of care
purpose of medical records- records are an excellent source of communicating w/ other mental health
professionals as well as other agencies. Used to validate reimbursement for care.
Facility use of medical records- track p/t's progress. Important for legal issues such as confidentiality &
privacy acts, accreditation, quality assurance, case management, utilization review, peer review, and research.
Medical record as evidence- legal document that is valuable in any litigation that takes place. Adequate &
legal documentation is the best means of defense against a lawsuit & the best way to validate that the nurse
adhered to their scope of practice & safe standard care.
Nursing guidelines for charting- Be specific and document symptoms by writing in quotes what the p/t
expresses to you. Chart in a timely & legible manner. Avoid late entries if not label & initial them. Document
when the person has achieved the goals outlined in the treatment plan. Informed consents.
1.7 discuss the ethical principles of autonomy, beneficence & distributive justice in relationship to ethical & legal
issues.
Autonomy- having respect for an individual's decisions or self-determination regarding health issues.
Important w/ problems such as the right to die &, in mental health, treatment w/ the use of the least restrictive
alternative. When involuntary commitment is necessary, it is difficult for mental health providers to have to
follow the law rather than to do what the p/t currently desires.

Beneficence- bringing about good. Promote wellness. first do no harm.

Giving neuroleptic medications when certain side effects are irreversible.
Consideration of giving ECT to a p/t who has failed to respond to anti-depressive medication and who
continue to be suicidal. Do the beneficial aspects of the treatment outweigh its possible side effects?
Limit the use of restraints & seclusion
no inappropriate staff sexual or intimate relationships w/ p/t
no personal relationships for a time period after discharge (per hospital policy)
Distributive Justice- comparative treatment of individuals in the allotment of benefits & burdens. A person
should be treated according to what is fair, given what is due or owned.
Parity- equal treatment for behavioral healthcare as with medical
advocate for p/ts to get the care they need from managed care companies. Document well & inform p/ts
of right to contest managed care decision

1.4 Neuro-Psychiatric Medications

1.1-1.13 Discuss neuroanatomy & neurophysiology of the human nervous system
Brain-most complex & vital of human organs
Frontal lobe-thought processes (largest most well developed lobe)
motor functions
insight & judgment/abstraction & decision making (executive functions)
Parietal lobe- sensory & motor
interprets sensory information
right & left orientation
Temporal lobe- auditory
connects w/ limbic system/allows expression of emotions, sexual arousal, aggression, fear
motivation
memory
Occipital lobe- vision
interprets visual images
involved in language formation
Basal Nuclei (ganglia)
associated w/ complex motor functions
Limbic system (thalamus, hypothalamus, epithalamus; amygdala, hippocampus)
instincts, drives, fear, aggression (emotional brain)
connects w/ olfactory pathways-certain smells evoke strong emotions & memories
Hypothalamus basic life functions
Sleep, rest, temperature, thirst, hunger, sex. Problems in schizophrenia.
Thalamus- relays all sensory info except smell filters incoming info regarding emotions, moods &
memory to prevent the cortex from becoming overloaded
Amygdala- emotional states, regulates affective responses to events. Panic-violent rage behavior.
Hippocampus- plays a role in the encoding, consolidation, & retrieval of memories. People w/
Alzheimers disease have problems with the hippocampus.
Cerebellum
motor coordination & balance-cognition
Brain-stem
regulator of respiration & heart rate
1.2-1.23 Discuss causal factors of disturbances of mental functioning
All neurons can respond to stimuli, conduct electrical impulses & release neurotransmitters
Neurotransmitters are chemicals that carry messages between the cells of the brain. Brain cells that transmit
messages are called neurons. Neurons have axons, which release neurotransmitters, and dendrites, to which

neurotransmitters bind at receptor sites. Axons and dendrites do not actually touch, but come very close. The
small gap between them is called a synapse. Neurotransmitters are released by axons into the fluid of the
synapse. Some of these chemicals bind to receptor sites on the corresponding dendrite, some of them return to
the axon, and some of them are broken down, or metabolized.
Steps
crosses synapse or gap b/t cells
attaches to receptor site
excites or inhibits cell to influence other neurons
after attaching to receptor sites that transmitter is :
deactivated by enzymes on the site or in the gap
taken back into the cell that released it and reused
deactivated by an enzyme in the cell
Identify the relationship of neurotransmitters in schizophrenia, mood disorders, Alzheimer disease, and
anxiety and describe the action of the major categories of drugs to treat these disorders:
A problem in impulse conduction
transmitter release
receptor response
Psychotropic drugs target these areas.
Categories of neurotransmitters:
Monoamides:
dopamine (malfunction in p/ts w/ schizophrenia & depression)
Norepinephrine (deficiencies in mood disorders I.e major depression. Foods high in tyrosine &
tyramine are avoided by p/ts who are taking certain psychotropic medications)
Serotonin (decreased in depression)
Histamine
Amino Acids
GABA (chemically derived from glutamate, inhibitory neurotransmitter)
Glutamine (excitatory neurotransmitter)
both are the subject of extensive research in disorders such as Alzheimer's disease & schizophrenia
Cholinergics
Acetycholine (Ach)
primarily involved in Alzheimer's disease
Neuropeptides
Substance P
Somatostatin
Neurotensin
CRH
Endorphin
Depression- serotonin, dopamine & norepinephrine. Major classes of antidepressantstricyclic
antidepressants & selective serotonin levels.
Anxiety- Panic disorders & extreme phobiasoverproduction of some excitatory neurotransmittersGABA
inhibitor
Neurotransmitter
Dysfunction
Mental disorder
Dopamine

Increase

Schizophrenia

Serotonin

Decrease

Depression

Norepinephrine

Decrease

Depression

GABA

Decrease

Anxiety disorders

Acetylcholine

Decrease

Alzheimer's disease

1.3 describe how mental disorders & psychotropic drugs alter the structure & function of the brain
Antipsychotic medication (typical & atypical)
Typical control psychotic symptoms such as delusions, hallucinations, and thought disorders (positive
symptoms)
first generation antipsychotic drugs
Phenothiazine & Non-Phenothiazine's act by blocking Dopamine, Acetylcholine, & epinephrine
Also block Norepinephrine & Histamine
side effects- extra pyramidal symptoms, dry mouth, orthostatic hypertension.
Haldol, Thorazine, Stelazine
Atypical Antipsychotics or 2nd generation:
Block dopamine (in a different way), block serotonin
Less side effects, few or no extra pyramidal symptoms
work on negative (decreased motivation, poor self-care, blunted effect) as well as positive symptoms of
schizophrenia
Clozaril, Zyprexa, Risperdal
Antidepressants (SSRI's, tricyclic's MAIO's)
treat depression & some anxiety disorders
Tricyclic antidepressants:
Elavil, Tofranil
block reuptake of norepinephrine, histamine, & serotonin
side effects- orthostatic hypotension, sedation.
Selective serotonin reuptake inhibitors (SSRI):
Prozac, Zoloft, Paxil
block reuptake of serotonin
may be used to reat OCS's & social phobias
Do not have the anticholinergic & sedating effect of TCA's.
1.4 Describe noninvasive structural & functional brain imaging techniques used to visualize the brain
Structural imaging shows gross anatomical details of brain structure
Computed Tomography (CT) detects:
lesions, infarct, aneurysms
schizophrenia: cortical atrophy, 3rd ventricle enlargement, cognitive disorders
contradictions- individuals w/ pacemakers; individuals w/ metallic objects such as screws, prostheses, &
orthopedic devices; p/ts on life-support systems
Magnetic Resonance Imaging (MRI) detects:
Brain edema, ischemia, infection, neoplasm & trauma
Schizophrenia: enlarged ventricles, reduction in temporal & frontal lobes
Functional imaging shows activity of the brain
Positron-emission tomography (PET) detects:
oxygen use, glucose metabolism, blood flow, some neurotransmitter interactions
schizophrenia- increased dopamine receptors, abnormalities in limbic system
mood disorder- abnormalities in temporal lobe
adult ADHD- decreased utilization of glucose
Single photon emission computed tomography (SPECT) detects:
similar to PET also measures brain function & provides images of multiple layers of the CNS

1.5 Empowerment for test success

1.1 identify methods to develop a positive mental attitude to control test anxiety
Challenge negative thoughts
Identify your pattern of talking to yourself

Replace the negative self-talk with positive self-talk that reflects control & strength. I want I Can I will

1.2 practice relaxation techniques to promote a positive mental attitude & reduce anxiety
Breathing
muscle relaxation
imagery
exercise
desensitize fear response
a routine
set goals for studying
find a suitable environment
control distracting in studying environment
prepare for class ahead of time
make sure to take notes
1.3 Manage daily routines & study habits before test day
decide what is needed & unneeded in a normal studying habit
set a normal routines
1.4 + 1.5 self-explanatory