Psych Psychopathology
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Transcript of Psych Psychopathology
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8/11/2019 Psych Psychopathology
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4
PREDISPOSING FACTORS
FAMILY SYSTEM THEORY
FST is a theory introduced by Dr.Murray ro!n that su""ests thatindi#idua$s cannot be understood iniso$ation %ro& one another' but rather as a(art o% their %a&i$y' as the %a&i$y is ane&otiona$ unit. Fa&i$ies are syste&s o%interconnected and interde(endentindi#idua$s' none o% !ho& can beunderstood in iso$ation %ro& the syste&.
The patient is under a strict familysince she is only the child in thefamily
She is dependent from the decisionof her parents. Given the fact thatshe is the only child in the familyand that her parents are still the onewho decides for her up to her adultyears, she might failed to achievesense of autonomy.
She experienced great frustrationswhen her choice of place to practiceher profession was not accepted byher family. Her family was the onewho decided where she should work
Her arents are both bus in their
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PSYCHOLOGICAL THEORY
Erikson's Psychosocial Development
Eri)son be$ie#ed that !hen a (erson reaches the a"e bet!een *+ to 4, years o$d' the &a-orconict centers on %or&in" inti&ate' $o#in" re$ationshi(s !ith other (eo($e. For hi&' it is #ita$ that(eo($e de#e$o( c$ose' co&&itted re$ationshi(s !ith other (eo($e because success in this sta"e $eads
to stron" re$ationshi(s' !hi$e %ai$ure resu$ts in $one$iness and iso$ation.
So far, our client was not able to achieve the virtue of love during her current stage since ather age, this theory proposes that she should have already achieved marital bond with amale partner.
Moreover, she kept on mentioning about her xed marriage to an imaginary Spaniard whichshe believes was planned by the !group of people! she says is controlling her. Signicantother verbali"ed that she had a deep admiration to her foreign#looking rst#degree cousinwhom she wants to get married with, but the man does not like the client. She has notformed intimate relationships with other people probably because she had a poor sense ofself which had not developed from the prior stage of psychosocial development. $identity vs.confusion stage%
Sullivan's Interpersonal Theory
Su$$i#an e&(hasi/ed that inter(ersona$ socia$i/ation o% hu&an bein"s throu"hout theirde#e$o(&enta$ sta"es. The &other &ay be be$ie#ed to be an0ious' o#er(rotecti#e' or co$d' andun%ee$in"1 !hi$e the %ather !as distant or o#erbearin". So&e theories described ho! a2schi/o(hreno"enic2 &other and other theories described ho! co&&unicatin" in doub$e &essa"escou$d 2doub$e b$ind2 a (erson into de#e$o(in" schi/o(hrenia.
The client is the only child in the family and both parents are protective to their onlydaughter. &nterpersonal relationship of the patient was focused on her mother, father,classmates, and friends. Signicant other verbali"ed that parents are strict towards theoutgoings of the client.
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SOCIO-CULTURAL & ENVIRONMENTAL THEORY
Social Model
So&e theorists (ro(osed that (o#erty' society' and cu$tura$ dishar&onycou$d cause schi/o(hrenia or that (eo($e chose to beco&e schi/o(hrenic toco(e !ith the insanity o% the &odern !or$d. Others (ro(osed that
schi/o(hrenia !as caused by $i#in" in the city or $i#in" in iso$ation in thecountry. A$thou"h accu&u$ated stress re$ated to sociocu$tura$ anden#iron&enta$ %actors is $i)e$y to be a contributin" %actor to the onset o%schi/o(hrenia and to re$a(ses' neurobio$o"ica$ 3ndin"s (oint to other causes%or the etio$o"y o% (sychotic disorders.
The patient came from a middle class family. She was able to studycollege in a 'niversity and nished a course in (sychology. She has notexperienced signicant or tremendous societal con)icts nor culturaldisharmony that we could look into as related to her disorder. However,one factor is that she is withdrawn from society since she has nofriends until her college years
The client was able to graduate a psychology degree in college andwas able to pass the (hilippine *oard +xam for Teachers
She was not also abusing any substance.
She was unemployed since she graduated college.
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Neurotransmitter Studies
Dysre"u$ation hy(othesis o% schi/o(hrenia or the
(ersistent i&(air&ent in one or &ore
neurotrans&itter ho&eostatic re"u$atory
&echanis&s causin" unstab$e or erratic
neurotrans&ission !hich (ro(oses that the
&eso$i&bic areas has o#eracti#e do(a&ine
(ath!ays' !hereas the do(a&ine (ath!ays in the
(re%ronta$ &esocortica$ areas are hy(oacti#e and
that an i&ba$ance e0ists bet!een do(a&ine and
serotonin neurotrans&itter syste&s.
Neurodevelopment
This research su""ests that so&e disru(tion in
%eta$ neura$ de#e$o(&ent &ay chan"e the !ay the
brain &atures throu"hout chi$dhood and
ado$escence' aectin" the &ye$ination' &i"ration'
and interconnections o% youn" neurons as they
&ature in utero and in the 3rst %e! decades a%ter
birth and thus &ay contribute to brain abnor&a$ities
co&&on in schi/o(hrenia.
Viral Theories
Mi0ed e#idence indicates that (renata$ e0(osure
to the inuen/a #irus' (articu$ar$y durin" the second
tri&ester' &ay be one o% the %actors in the etio$o"y
o% schi/o(hrenia in so&e (eo($e but not in others.
Genetic
Studies ha#e identi3ed that certain"enetic %actors &ay be in#o$#ed in thede#e$o(&ent o% a (sychotic disorder. Resu$tsha#e sho!n that indi#idua$s are at hi"her ris) %orthe disorder i% there is %a&i$ia$ (attern o%in#o$#e&ent 5(arents' sib$in"s and otherre$ati#es6
The patients genetic predisposition isunknown. She did not report anyone fromher family that has a mental disorder.
Biochemical
A bioche&ica$ theory su""ests thein#o$#e&ent o% e$e#ated $e#e$s o% theneurotrans&itter do(a&ine' !hich is thou"ht to(roduce the sy&(to&s o% o#eracti#ity and%ra"&entation o% associations that are co&&on$yobser#ed in (sychosis.
Neuroiolo!y
Research su""ests that the (re%ronta$ corte0and the $i&bic corte0 &ay ne#er %u$$y de#e$o( inthe brains o% (ersons !ith schi/o(hrenia. The t!o&ost consistent neurobio$o"ica$ research 3ndin"sin schi/o(hrenia are i&a"in" studies sho!in"decreased brain #o$u&e and abnor&a$ %unction'and neuroche&ica$ studies sho!in" a$terations o%nu&erous neurotrans&itter syste&s. This hasbeen recent$y attributed to %au$ty &ye$inationoccurrin" at about a"e 7 and a"ain at about *8.
The client was not tested with M-& nor Tscans, hence neurobiology aspect was notassessed.
Do(a&ine is increased in c$ient9s
&eso$i&bic area !hi$e decreased in
(re%ronta$ &esocortica$ areas.
BIOLOGIC THE
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PRECIPITATING FACTORS
Loss of Attachmet!L"fe E#ets
:oss in adu$t $i%e can (reci(itate de(ression. The $oss &ay be rea$ or i&a"ined and &ay inc$ude o% $o#e' a (erson' (hysica$ %unctionin"' status'
or se$%;estee&. Many $osses ta)e on i&(ortance because o% their sy&bo$ic &eanin" !hich &a)es the reaction to the& a((ear out o% (ro(ortion torea$ity. In this sense' e#en an a((arent$y ($easurab$e e#ent' such as &o#in" to a ne! ho&e' &ay in#o$#e the $oss o% %riends' !ar& &e&ories' and
nei"hborhood associations.
The intensity o% "rie% beco&es &eanin"%u$ on$y !hen the (erson understands ear$ier $osses and se(arations. Peo($e reactin" to a recent $oss
o%ten beha#e as they did in (re#ious se(arations. The intensity o% the (resent reaction there%ore beco&es &ore understandab$e !ith the rea$i/ation
that the reaction is to ear$ier $ose as !e$$. y de3nition $oss is ne"ati#e' a de(ri#ation. The abi$ity to sustain' inte"rate' and reco#er %ro& $oss is a
si"n o% (ersona$ &aturity and "ro!th.
$Give the explanation on the case of the patient%
Ad#erse $i%e e#ents are a (otent %actor in (reci(itatin" de(ression. Such e#ents inc$ude $oss o% se$%;estee&' inter(ersona$ discord' socia$$y
undesirab$e occurrences' and &a-or disru(tions o% $i%e (atterns. E#ents (ercei#ed as undesirab$e are &ost o%ten the (reci(itants o% de(ression.
$Give the explanation on the case of the patient%
Hea$th
This inc$udes (oor nutrition' $ac) o%s$ee(' out o% ba$ance circadian rhyth&s'%ati"ue' in%ection' CNS dru"s' $ac) o%e0ercise' barriers to accessin" hea$th care.
She had no problems with regards toher nutrition, sleep, past infection,lack of exercise and she had no pastexperience of using /S drugs. /owthat she is admitted to theinstitution, we observed that our
patient is picky when it comes tofood. She wont eat if not in her foodpreferences. &t is also stated in herrecord that she had poor complianceof her medications at homewhenever she is discharged.
Att"t%e!Beha#"o's
This co&(ro&ise the %o$$o!in"< =Poo5$o! se$% conce(t6' =ho(e$ess> 5$ac) o% se$%con3dence6' =I?& a %ai$ure> 5$oss o% &oti#atto use s)i$$s6' =:ac) o% contro$> 5de&ora$i/a%ee$in" o#er(o!ered by sy&(to&s' =no one&e> 5unab$e to &eet s(iritua$ needs6' $oo)sdierent %ro& others !ho are o% the sa&e aand cu$ture' (oor socia$ s)i$$s' a""ressi#ebeha#ior' (oor &edication &ana"e&ent' a(oor syste& &ana"e&ent.
The patient may have had a 0hopeleand 0poor me1 attitude of herinterpersonal di2culties since sheexperience failure in her profession.claimed that she tried to apply indi3erent works but failed to be part Her choice of profession is also hindeby her parents.
She may also have felt 0lack of contrbecause she did not understand hersymptoms and why they were happeto her, she keeps on telling us that thshe is normal and it really hurts her placed inside the rehabilitation eventhough she is not psychotic.
4n her record she has the followingreason of admission5
E#"'omet
The $ist co&(oses the %o$$o!in" instead she
wants happy thoughts to be
discussed.
Fai$ure to ac)no!$ed"e an unbearab$e
condition1 %ai$ure to ad&it the rea$ity o%
a situation' or ho! one enab$es the
(rob$e& to continue.
=hen asked why she doesnt
comply with her medications she
verbali"ed 0Mu tumar ra man ko1 She keeps on telling us that that
she is normal and it really hurts
her to be placed inside the
rehabilitation even though she is
not psychotic. She also believed that her
mother is still alive and is
working in ?merica.
Acce(tin" another (erson?s attitudes'
be$ie%s' and #a$ues as one?s o!n.
The client verbali"ed that what
she has today came from her
family and relatives. She
believes that they own 0anting @
anting1 and it is passed on to
her and that it possesses great
powers.
E0cessi#e reasonin" or $
used to a#oid e0(erienc
disturbin" %ee$in"s.
She verbali"ed th
does not want to
her psychotic
medications beca
believed that it ca
cause harm to her
She verbali"ed , 0
meds kay makaca
harm sa body uny
normal ra man ko
man ko psychopa
sakit gyud kaayo
patumaron ko nila
tambal1
COPING MECANISM
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ADAPTIBE RESPONSES
!ith (rob$e&s. She (rays that he %ather !i$$ be a$!ays there !ith her or #isit her &ost o% the ti&e.
o% the acti#ities' she ta$)s !ith (eo($e !ho& she (re%erred to. She shares her $i%e to the student nurses durin" the interaction but on$y &ini&a$ in%or&ation b
F$%*hea."e /eca%ate 0 cc
Ch$o'*'oma."e 001) ta( O/
A2"eto 31 m) 0 ta( O/
Res"o 3 m) ta( 0 ta( BI/ PSCOSIS
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oBe *'e*a'e to
'e"'ect the
*at"et (ac2 to MA:ADAPTIBE RESPONSES
COGNITIONPOSITIVE SYMPTOMS
"allucinationsa. Auditory a$$ucinations
; Aerbali"ed 0 Sulti an ra man ko unsa ako buhaton na sakto1b. Bisua$ a$$ucinations
; :uring one of our /(&, upon our arrival she verbali"ed 0Gimagic mo saB, /igawas ra lage mo kalitB1.
She believed that we came from nowhere Delusions#Thou!ht Disorder
a. Grandiose; e$ie% that one has e0ce(tiona$ (o!ers' !ea$th' s)i$$' inuence' or destiny; She believe that she possessed great powers and that they are related to the government o2cials
$?rnai", Teves, Aillegas%.; She strongly believed that her mom is still alive that it is possible for them to do everything they wa
because they CfamilyD believed that they possessed great power.b. Persecutory
; The be$ie% that one is bein" !atched' ridicu$ed' har&ed' or ($otted a"ainst.; Aerbali"ed 0 Mahadlok man ko dire kay patyon man nya ko1. 0:ire sa mo ayaw sa mo lakaw1
Di$%culty maintainin! attention &Distractiility; Distracted attention is i&(air&ent in the abi$ity to (ay attention' obser#e and concentrate on e0tern
rea$ity.; She is easily distracted with external stimuli, her attention is easily caught by what she hear and wh
she see.
Disor!ani(ed speech and ehavior
; C$ient &ani%ested $a(ses o% incoherenceas a (ositi#e %or&a$ thou"ht disorder.
Assess a
oc%met
*at"et4so'"etat"o5
Ca$$ *at"et
(+ ame5 S*e t"me
6"th the
c$"et to
ta$2 a
eco%'a)e
#e'(a$".at"o
of
fee$")s5 Be s"ce'e
a hoest6he
comm%"ca
t") 6"th
the c$"et5 Be
cos"stet
6"th the
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NDIFFERENTIATED
Ass"st the
c$"et "
act"#"t"es
that foste'
soc"a$$+
acce*ta($e
"te'act"os
6"th othe's Soc"a$".at"o
th'o%)h
Assess the
c$"ets
a("$"t+ to
o se$f
ca'e Eco%'a)e
a ass"st
c$"et to
ta2e a
(ath7 c$ea
he' teeth7cha)e
c$othes
a ha#e
6e$$
PHYSICAL
Deterioration in )ppearance and *ack o%
persistence+
Dirty C$othes n)e&(t A((earance Poor Groo&in" Persona$ y"iene
o
She doesnt take a bath regularly. Sheonly takes a bath depending on her own
preference. S$o! Mo#e&ents FreHuent Starin" Poor Eatin" abits
o The client is picky when it comes to food.
She wont eat if its not her food
preference. Does not (artici(ate in so&e acti#ities
o :uring the excursion closing program
the client doesnt want to participate in
the games and also doesnt want toanswer the ;uestion during the
evaluation of the activity.
NEGATIVE SYMPTOMS8
Di,culty processin! emotions- Prob$e&s o% e&otion