Maryville University NURS 661 Exam 3 Summer updated 2022/2023

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Who is at highest risk of suicide? White, elderly men Schizophrenia Single, never married, divorced, recently widowed Previous attempts Adolescents with depression, bullied, or family hx of suici... de Who is most likely to succeed at committing suicide? Older while males What are some protective factors for suicide? Having children Religion Stronger alliances with medical providers and therapists What is lethality? the probability that a person will successfully complete suicide What is intent? Effective expectations for desire of active death What is a suicide attempt? Includes all willful, self-inflicted life-threatening attempts that have not led to death What is suicidal ideation? thinking about suicide, usually with some serious emotional and intellectual or cognitive overtones Where in the brain do we theorize violence and aggression originate? Prefrontal cortex How to assess for homicidal ideation? Do you have homicidal ideation? Who do you want to kill? How do you plan to do this? Do you have access to the means necessary? Do you intend to commit the act? What legal follow up is needed for homicidal ideation? Duty to warn Based on state laws Obsession 1. Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress 2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e. by performing a compulsion) Compulsion 1. Repetitive behaviors or mental acts that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly 2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation, however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive Obsessive-Compulsive Disorder (OCD) A. Presence of obsessions, compulsions, or both B. The obsessions or compulsions are time-consuming (e.g. take more than one hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance or another medical condition D. The disturbance is not better explained by the symptoms of another mental disorder PANDAS Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections OCD common co-morbid conditions MDD (Major depressive disorder) Skin Picking Hair Pulling Most Common Compulsions Checking Ordering Arranging Washing/cleaning Hand-washing Flipping lights Counting Differentiation between OCD and eating disorders Those with eating disorders will be counting calories, focused on weight loss or maintaining a specific weight Treatment for OCD Cognitive Behavioral Therapy Pharmacological Treatment for OCD First line treatment-SSRI (Luvox, fluoxetine) Second-line treatment TCA with serotonergic properties (clomipramine) SNRI or MAOI Augmentation with benzos, lithium, or Buspar DSM-5 Body Dysmorphic Disorder Preoccupation with perceived flaw on body taht is not observed by others Repetitive behaviors such as mirror checking, excessive grooming, skin picking, reassurance seeking, clothes changing Clinical significance Differentiation from eating disorder BDD common preoccupations Facial flaws genitalia Differentiation between BDD and eating disorders BDD is more obsessed with one specific body flow, not the entire body Differentiation between BDD and OCD OCD may have food rituals but not obsession on a specific body flaw Treatment for BDD Cognitive Behavioral Therapy Pharmacological treatment of BDD Clomipramine and fluoxetine reduce symptoms in about 50% of patients [Show More]

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