NURS661 Study Guide for Exam 1 Final Copy
• Know what Socratic Dialogue is and why it is used
Non-directive: therapists’ interpretations are thought to lead the patient into insight, integration,
and change. Therapist guides pt. through a series of questions and answers to elicit
automatic thoughts and assumption and examines the logic and evidence that relates to
them. The therapist asks specific questions derived primarily from restatement of the
individuals’ own words as the major technique where the individual can self-discover insight
which leads to subsequent changes. Use of guided discovery using SD appears relaxed and
nonconfrontational, with the therapist genuinely listening and reflecting what the patient is
saying. The SD process includes seven types of questions: memory, translation, interpretation,
application, analysis, synthesis, and evaluation. This type of therapy helps the patient find the
answer for him or herself. This is a hallmark of CBT.
Cornerstone of CBT, therapist guides the pt through a series of questions and clarification
to a point of self-discovery. Therapist doesn’t come out and say what they want to they want
pts to come to their realization
• Know what the Diathesis-Stress model is what it is used for
Recognizes that genetics, nature, and the environment, stress contribute to psych disorders.
Person may have genetic vulnerability & Significant stress in early life can lead to mental health
disorders= change in DNA with the process of methylazation. the theory that mental and physical
disorders develop from a genetic or biological predisposition for that illness (diathesis) combined
with stressful conditions that play a precipitating or facilitating role. is a psychological theory
that attempts to explain behavior as a predisposition vulnerability together with stress from life
experiences. diathesis. vulnerability to mental illness. stress. a state of mental or emotional strain
or tension resulting from adverse or very demanding circumstances.
Person who has genetic vulnerability +life stressors or childhood trauma etc.= psych disorder is
TRIGGERED. (Like a predisposition) this is countered by having parental nurturing. However,
in the absence of parental nurturing regulatory and attention problems result. (Page 23, 24
Chapter 1) Think bipolar and schizophrenia as examples
Genetics, Environment and stress come together to play a part in mental health (Nature Vs
Nurture)
• Know what the HPA axis and why is it important
The HPA axis regulates cortisol, a potent hormone that inhibits growth, immune responses, and
inflammatory responses.
Plays a role in ACTH, it is important because the pathway of the HPA axis results in production
of cortisol. ACTH comes from the anterior pituitary (above the brainstem). HPA plays a role in
fight or flight, stress hormone.
,Chronic stress leads to activation of the HPA axis. Examples of chronic stress include constant
work troubles, debt, and other situations that arise in everyday life.
Adrenaline (Epinephrine) is a stimulant that causes the body to prepare to fight. You want
more blood in the muscles and a higher blood pressure to allow your body to resist a hit. To get
the additional blood in your muscles, your body takes it from the frontal lobe.
Many people make the mistake of substituting 'hippocampus' for 'hypothalamus.' The
hypothalamus is the control center of the brain and autonomic body systems, and it is a
component of the HPA axis. The three components of the HPA axis is: hypothalamus,
pituitary, and adrenals.
The various chemicals released by the adrenal glands damages the body. The system functions
best in short bursts, providing energy and strength at the expense of some damage. Chronis
activation of the HPA axis can damage the body and lead to memory impairment, heart problems
and wearing down of the heart and muscles.
Hypothalamic pituitary and adrenal glands. Plays a role in the body’s response to stress. The
pathway of the axis results to the reduction of cortisol.
• Know what cortisol is and how PTSD affects cortisol production
A person with PTSD has chronically lower levels of cortisol and, when and if traumatized
again, a blunted cortisol response occurs with a quicker return to baseline. Cortisol is a stress
hormone.
• Know the risk factors for eating disorders
Body image Dissatisfaction with oneself
Perfectionism with their behaviors- Self orientated perfectionism “setting unrealistic
high expectation of yourself”
Body image
distortion History of
anxiety Female
Age, Lates teens (early 20s)
Close relative with an eating disorder or mental condition (anxiety depression addiction)
Type 1 insulin dependent
Hx of anorexia
Weight stigma
Teasing
bullying
Internalization of
appearance Historical
trauma
Limited social
network anorexia
, • Know Erikson’s stages of development
Infancy (birth to 18 Trust Vs Mistrust •
months)
Early childhood (18 Autonomy Vs Self Doubt •
months to 3 yrs)
Late childhood (3 to 6 yrs) Initiative vs guilt •
School Age (6 to 12 yrs) Industry Vs Inferiority •
Adolescence (12 to 20 yrs) Identity Vs Role •
Confusion
Young Adulthood (20-30 Intimacy Vs Isolation •
yrs)
Adulthood (30-65 yrs) Generativity Vs •
Stagnation
Old Age (65 yrs to death) Ego integrity vs despair •
(Know ages and stages of development those are associated with)
1. The conflict between trust and mistrust defines the oral-sensory stage
2. According to Erik Erikson, psychosocial identities involve the interplay between
our emotional lives and our social circumstances.
3. An elderly adult who feels content about her life is experiencing ego integrity.
4. The struggle between intimacy and isolation is most common during
the late adulthood stage.
5. An identity crisis is most likely to take place during the adolescent stage.
• Know Freud’s psychosexual stages
Stage Age Focus of Libido Development Adult Fixation
Oral 0-1 yr mouth Feeding; could develop Smoking, biting
issues with dependency if nails. Overeat
disrupted
Anal 1-3 yrs anus Toilet training; learning Orderliness and
a sense of control, messiness
accomplishment, and
independence
Phallic 3-6 yrs genital Oedipus/electra Sexual
complexes. Boys and girls dysfunction
will look up to their
parents
Latent 6-12 yrs None Socialism and No
development of new development
• Know what Socratic Dialogue is and why it is used
Non-directive: therapists’ interpretations are thought to lead the patient into insight, integration,
and change. Therapist guides pt. through a series of questions and answers to elicit
automatic thoughts and assumption and examines the logic and evidence that relates to
them. The therapist asks specific questions derived primarily from restatement of the
individuals’ own words as the major technique where the individual can self-discover insight
which leads to subsequent changes. Use of guided discovery using SD appears relaxed and
nonconfrontational, with the therapist genuinely listening and reflecting what the patient is
saying. The SD process includes seven types of questions: memory, translation, interpretation,
application, analysis, synthesis, and evaluation. This type of therapy helps the patient find the
answer for him or herself. This is a hallmark of CBT.
Cornerstone of CBT, therapist guides the pt through a series of questions and clarification
to a point of self-discovery. Therapist doesn’t come out and say what they want to they want
pts to come to their realization
• Know what the Diathesis-Stress model is what it is used for
Recognizes that genetics, nature, and the environment, stress contribute to psych disorders.
Person may have genetic vulnerability & Significant stress in early life can lead to mental health
disorders= change in DNA with the process of methylazation. the theory that mental and physical
disorders develop from a genetic or biological predisposition for that illness (diathesis) combined
with stressful conditions that play a precipitating or facilitating role. is a psychological theory
that attempts to explain behavior as a predisposition vulnerability together with stress from life
experiences. diathesis. vulnerability to mental illness. stress. a state of mental or emotional strain
or tension resulting from adverse or very demanding circumstances.
Person who has genetic vulnerability +life stressors or childhood trauma etc.= psych disorder is
TRIGGERED. (Like a predisposition) this is countered by having parental nurturing. However,
in the absence of parental nurturing regulatory and attention problems result. (Page 23, 24
Chapter 1) Think bipolar and schizophrenia as examples
Genetics, Environment and stress come together to play a part in mental health (Nature Vs
Nurture)
• Know what the HPA axis and why is it important
The HPA axis regulates cortisol, a potent hormone that inhibits growth, immune responses, and
inflammatory responses.
Plays a role in ACTH, it is important because the pathway of the HPA axis results in production
of cortisol. ACTH comes from the anterior pituitary (above the brainstem). HPA plays a role in
fight or flight, stress hormone.
,Chronic stress leads to activation of the HPA axis. Examples of chronic stress include constant
work troubles, debt, and other situations that arise in everyday life.
Adrenaline (Epinephrine) is a stimulant that causes the body to prepare to fight. You want
more blood in the muscles and a higher blood pressure to allow your body to resist a hit. To get
the additional blood in your muscles, your body takes it from the frontal lobe.
Many people make the mistake of substituting 'hippocampus' for 'hypothalamus.' The
hypothalamus is the control center of the brain and autonomic body systems, and it is a
component of the HPA axis. The three components of the HPA axis is: hypothalamus,
pituitary, and adrenals.
The various chemicals released by the adrenal glands damages the body. The system functions
best in short bursts, providing energy and strength at the expense of some damage. Chronis
activation of the HPA axis can damage the body and lead to memory impairment, heart problems
and wearing down of the heart and muscles.
Hypothalamic pituitary and adrenal glands. Plays a role in the body’s response to stress. The
pathway of the axis results to the reduction of cortisol.
• Know what cortisol is and how PTSD affects cortisol production
A person with PTSD has chronically lower levels of cortisol and, when and if traumatized
again, a blunted cortisol response occurs with a quicker return to baseline. Cortisol is a stress
hormone.
• Know the risk factors for eating disorders
Body image Dissatisfaction with oneself
Perfectionism with their behaviors- Self orientated perfectionism “setting unrealistic
high expectation of yourself”
Body image
distortion History of
anxiety Female
Age, Lates teens (early 20s)
Close relative with an eating disorder or mental condition (anxiety depression addiction)
Type 1 insulin dependent
Hx of anorexia
Weight stigma
Teasing
bullying
Internalization of
appearance Historical
trauma
Limited social
network anorexia
, • Know Erikson’s stages of development
Infancy (birth to 18 Trust Vs Mistrust •
months)
Early childhood (18 Autonomy Vs Self Doubt •
months to 3 yrs)
Late childhood (3 to 6 yrs) Initiative vs guilt •
School Age (6 to 12 yrs) Industry Vs Inferiority •
Adolescence (12 to 20 yrs) Identity Vs Role •
Confusion
Young Adulthood (20-30 Intimacy Vs Isolation •
yrs)
Adulthood (30-65 yrs) Generativity Vs •
Stagnation
Old Age (65 yrs to death) Ego integrity vs despair •
(Know ages and stages of development those are associated with)
1. The conflict between trust and mistrust defines the oral-sensory stage
2. According to Erik Erikson, psychosocial identities involve the interplay between
our emotional lives and our social circumstances.
3. An elderly adult who feels content about her life is experiencing ego integrity.
4. The struggle between intimacy and isolation is most common during
the late adulthood stage.
5. An identity crisis is most likely to take place during the adolescent stage.
• Know Freud’s psychosexual stages
Stage Age Focus of Libido Development Adult Fixation
Oral 0-1 yr mouth Feeding; could develop Smoking, biting
issues with dependency if nails. Overeat
disrupted
Anal 1-3 yrs anus Toilet training; learning Orderliness and
a sense of control, messiness
accomplishment, and
independence
Phallic 3-6 yrs genital Oedipus/electra Sexual
complexes. Boys and girls dysfunction
will look up to their
parents
Latent 6-12 yrs None Socialism and No
development of new development
