NURS661 Exam 3 Maryville university
(Answered) 2023
What area of the brain is most often linked to violence among patients?
Prefrontal- cortex
Which personality disorder is often associated with self-harming behavior?
BPD
Know the risk factors associated with suicide among patients
Family history of suicide
Family history of child maltreatment
Previous suicide attempt(s)
History of mental disorders, particularly clinical depression
History of alcohol and substance abuse
Feelings of hopelessness
Impulsive or aggressive tendencies
Cultural and religious beliefs (e.g., belief that suicide is noble resolution of a personal
dilemma)
Local epidemics of suicide
Isolation, a feeling of being cut off from other people
Barriers to accessing mental health treatment
Loss (relational, social, work, or financial)
Physical illness
Easy access to lethal methods
Unwillingness to seek help because of the stigma attached to mental health and
substance abuse disorders or to suicidal thoughts
Single, living alone
Be able to identify protective factors among patients at risk for suicide
Effective clinical care for mental, physical, and substance abuse disorders
Easy access to a variety of clinical interventions and support for help seeking
Family and community support (connectedness)
Support from ongoing medical and mental health care relationships
Skills in problem solving, conflict resolution, and nonviolent ways of handling disputes
Cultural and religious beliefs that discourage suicide and support instincts for self-
preservation
difference between suicidal gestures and self mutilation
**INTENT
**suicide: experiencing stressors for which they see no escape from, and choose to end
life- feel worthless and hopeless
** the infliction of pain reassures them that they are still alive, which is especially true if
they are experiencing emotional numbness or are feeling disconnected from the world
around them. Additionally, self-injury can result in a rush as a result of chemical
changes in the brain, which can easily become addictive and highly dangerous.
What is self harm?
Self-harm is a form of mutilation while suicide is the deliberate act of taking one's own
life.
, Know which medication has been linked to reducing suicidal ideation among
patients
Lithium
Understand what lethality means
the capacity to cause death or serious harm or damage.
who are the patients with the highest lethality?
Narcissists
What compulsion is most commonly seen in patients with OCD?
Checking 63%
Washing 50%
Counting 36%
Need to ask or confess 31%
Symmetry and precision 28%
Hoarding 18%
What is an obsession?
intrusive thoughts
What is a compulsion?
irrational behavior performed repeatedly
How would these (obsession and compulsion) present in a case scenario
(Hoarding)
Characterized by acquiring and not discarding things deemed to be of little to no value;
was originally considered a subtype of OCD, but now considered its own diagnostic
entity
Epidemiology of obsession and compulsion (Hoarding
~2-5% of population, some research shows prevalence as high as 14%
Etiology of compulsion and obsession (Hoarding)
80% of hoarders with one 1st degree relative
Biological of compulsion and obsession (Hoarding)
lower metabolism in the posterior cingulate cortex and occipital cortex or hoarders, may
account for cognitive impairments, such as attention and decision making deficits
Genetics of compulsion and obsession (Hoarding)
link between hoarding behavior and markers on chromosome 4q, 5q, 17q; another
study found COMT gene on chromosome 22q11.21 might contribute to susceptibility
Clinical features of compulsion and obsession (Hoarding)
accumulate possessions passively rather than intentionally; hoarding can interfere with
work, social interactions, and basic activities like eating and sleeping; inability to
organize possessions; at the core, hoarders are driven by the fear of losing items (ie.
keeping piles of old newspapers, because of the belief that forgetting information will
lead to serious consequences; onset due to stressful event
treatment of compulsion and obsession (Hoarding)
does not usually occur until 40-50s, even if began in adolescence; patient have very
little insight into their behavior, usually seek treatment under pressure; difficult to treat,
effective treatments for OCD show little benefit with hoarding; in one study 18%
responded to CBT and meds
What is the first line treatment for hoarding disorder?
(Answered) 2023
What area of the brain is most often linked to violence among patients?
Prefrontal- cortex
Which personality disorder is often associated with self-harming behavior?
BPD
Know the risk factors associated with suicide among patients
Family history of suicide
Family history of child maltreatment
Previous suicide attempt(s)
History of mental disorders, particularly clinical depression
History of alcohol and substance abuse
Feelings of hopelessness
Impulsive or aggressive tendencies
Cultural and religious beliefs (e.g., belief that suicide is noble resolution of a personal
dilemma)
Local epidemics of suicide
Isolation, a feeling of being cut off from other people
Barriers to accessing mental health treatment
Loss (relational, social, work, or financial)
Physical illness
Easy access to lethal methods
Unwillingness to seek help because of the stigma attached to mental health and
substance abuse disorders or to suicidal thoughts
Single, living alone
Be able to identify protective factors among patients at risk for suicide
Effective clinical care for mental, physical, and substance abuse disorders
Easy access to a variety of clinical interventions and support for help seeking
Family and community support (connectedness)
Support from ongoing medical and mental health care relationships
Skills in problem solving, conflict resolution, and nonviolent ways of handling disputes
Cultural and religious beliefs that discourage suicide and support instincts for self-
preservation
difference between suicidal gestures and self mutilation
**INTENT
**suicide: experiencing stressors for which they see no escape from, and choose to end
life- feel worthless and hopeless
** the infliction of pain reassures them that they are still alive, which is especially true if
they are experiencing emotional numbness or are feeling disconnected from the world
around them. Additionally, self-injury can result in a rush as a result of chemical
changes in the brain, which can easily become addictive and highly dangerous.
What is self harm?
Self-harm is a form of mutilation while suicide is the deliberate act of taking one's own
life.
, Know which medication has been linked to reducing suicidal ideation among
patients
Lithium
Understand what lethality means
the capacity to cause death or serious harm or damage.
who are the patients with the highest lethality?
Narcissists
What compulsion is most commonly seen in patients with OCD?
Checking 63%
Washing 50%
Counting 36%
Need to ask or confess 31%
Symmetry and precision 28%
Hoarding 18%
What is an obsession?
intrusive thoughts
What is a compulsion?
irrational behavior performed repeatedly
How would these (obsession and compulsion) present in a case scenario
(Hoarding)
Characterized by acquiring and not discarding things deemed to be of little to no value;
was originally considered a subtype of OCD, but now considered its own diagnostic
entity
Epidemiology of obsession and compulsion (Hoarding
~2-5% of population, some research shows prevalence as high as 14%
Etiology of compulsion and obsession (Hoarding)
80% of hoarders with one 1st degree relative
Biological of compulsion and obsession (Hoarding)
lower metabolism in the posterior cingulate cortex and occipital cortex or hoarders, may
account for cognitive impairments, such as attention and decision making deficits
Genetics of compulsion and obsession (Hoarding)
link between hoarding behavior and markers on chromosome 4q, 5q, 17q; another
study found COMT gene on chromosome 22q11.21 might contribute to susceptibility
Clinical features of compulsion and obsession (Hoarding)
accumulate possessions passively rather than intentionally; hoarding can interfere with
work, social interactions, and basic activities like eating and sleeping; inability to
organize possessions; at the core, hoarders are driven by the fear of losing items (ie.
keeping piles of old newspapers, because of the belief that forgetting information will
lead to serious consequences; onset due to stressful event
treatment of compulsion and obsession (Hoarding)
does not usually occur until 40-50s, even if began in adolescence; patient have very
little insight into their behavior, usually seek treatment under pressure; difficult to treat,
effective treatments for OCD show little benefit with hoarding; in one study 18%
responded to CBT and meds
What is the first line treatment for hoarding disorder?
