Title: Essentials of Human Diseases and Conditions 4th edition
1Essentials of Human Diseases and Conditions 4th
edition
- Margaret Schell Frazier
- Jeanette Wist Drzymkowski
2Chapter 14 Mental Disorders
3Learning Objectives
- Name some contributing factors to mental
disorders. - List some of the many causes of mental
retardation. - Describe the characteristic manifestations of
autism. - List some examples of tic disorders.
4Learning Objectives (contd.)
- Describe the progressive degenerative changes in
an individual with Alzheimer disease. - Explain important factors in the treatment of
Alzheimer disease. - Explain the cause of vascular dementia.
- Relate treatment options for alcohol abuse.
5Learning Objectives (contd.)
- Name the classic signs and symptoms of
schizophrenia. Explain what is included in the
multidimensional treatment plan. - Explain why bipolar disorder is considered a
major affective disorder. Describe the treatment
approach. - Explain the difference between reactive
depression and a major depressive disorder.
6Learning Objectives (contd.)
- Name the distinguishing characteristics of
personality disorders. - Discuss how each type of anxiety disorder
prevents a person from leading a normal life. - Explain how posttraumatic stress disorder (PTSD)
differs from other anxiety disorders.
7Learning Objectives (contd.)
- Explain how a somatization disorder is diagnosed.
- Discuss the relationship between anxiety and
conversion disorder. - Describe Munchausen syndrome.
- Contrast insomnia to narcolepsy.
8Chapter 14 Lesson 14.1
9Mental Wellness and Mental Illness
- Mental wellness The capacity to cope and adjust
to the ongoing stresses of everyday life. - Mental illness Difficulty coping with ongoing,
everyday stresses, which results in psychological
pain and possibly affects physical health.
10Mental Wellness and Mental Illness (contd.)
- mental disorders could be caused by
- heredity
- congenital factors
- accident
- trauma
- drug toxicity
- stress
11Mental Wellness and Mental Illness (contd.)
- mental disorders are loosely classified as
- maladaptive disorders
- phobias
- anxiety
- depression
- addiction
12Mental Wellness and Mental Illness (contd.)
- Diagnostic and Statistical Manual of Mental
Disorders, fourth edition, is - standard reference used in a clinical setting to
diagnose mental disorders - published by the American Psychiatric Association
- also referred to as DSM-IV
13Mental Wellness and Mental Illness (contd.)
- DSM-IV categorizes mental illnesses by using a
five-axis system to measure different parts of
the overall diagnosis. - Axis I mood and thought disorders
- Axis II mental retardation and personality
disorders - Axis III medical conditions that contribute to
the psychological condition - Axis IV stressors that contribute to the overall
psychological condition - Axis V GAF (Global Assessment of Functioning)
assigns a number from 0 to 100 that indicates
level of functioning
14Mental Retardation
- Mental retardation Subnormal intellectual
development as a result of - congenital causes
- brain injury
- disease
- characterized by any of various cognitive
deficiencies, including impaired learning,
social, and vocational ability
15Mental Retardation Causes
- predisposing factors
- heredity (genetic or chromosomal disorders)
- early alterations of embryonic development (Down
syndrome, toxin exposure) - prenatal, perinatal, or postnatal conditions
(infections, trauma, poisoning, hypoxia) - environmental influences
16Mental Retardation Symptoms
- few noticeable symptoms during early childhood
- as child grows and enters school, deficits become
more obvious and can include - delayed development of communication and motor
skills - difficulty with school work and social
relationships. - lack of control of emotions
17Mental Retardation Diagnosis
- intelligence tests routinely used to develop
intelligence quotient (IQ) - example Stanford-Binet test
- 110-90 average
- 90-70 below average
- 70-50 mild retardation
- 50-35 moderate retardation
- 35-20 severe retardation
- below 20 profound retardation
18Mental Retardation Diagnosis (contd.)
- criteria for diagnosis of mental retardation
- subaverage intellectual functioning
- limitations in at least two of the following
- communication
- home living
- self-care
- social or interpersonal skills
- self-direction
- health and safety
19Mental Retardation Treatment
- No cure or drug therapy is available.
- Underlying causes should be treated.
- Training should be provided to teach important
tasks, foster independence, and prevent further
delay in development.
20Learning Disorders
- Learning disorders Conditions that cause
children to learn in a manner that is not normal.
- Performance on standardized tests is lower than
expected for age, schooling, and intelligence
level. - The person with a learning disorder exhibits
difficulty in acquiring a skill in a specific
area of learning, such as reading, writing, and
mathematics.
21Learning Disorders Diagnosis
- A diagnosis is made when the child meets all
DSM-IV diagnostic criteria. - Additional tests are then performed to rule out
inadequate schooling, language barrier, poor
teaching, etc. - Hearing and vision tests also are given.
- Other mental disorders are ruled out.
22Learning Disorders Treatment
- drug therapy for those with hyperactivity,
usually with stimulants - instructional techniques (tutoring, counseling,
social skills)
23Communication Disorders Stuttering
- Stuttering The frequent repetition or
prolongations of sounds or syllables. - Stuttering appears to run in families and is more
frequently seen in males. - Anxiety appears to be a major factor that creates
and maintains the behavior.
24Stuttering Treatment
- Speech therapy can be very beneficial.
- The condition can resolve spontaneously.
25Pervasive Development Disorder
- Pervasive development disorder Indicates a
severe impairment in several areas of
development, including communication and social
interaction skills.
26Autistic Disorder
- Autistic disorder A syndrome of extreme
withdrawal and obsessive behavior. - has its onset in infancy and becomes evident in
the second or third year
27Autistic Disorder Symptoms
- marked impairment in nonverbal communication
- absent or delayed verbal communication
- inability to initiate conversation
- does not initiate age-appropriate play
- repetitive motions
- inflexibility toward change
- failure to establish normal peer relationships
28Autistic Disorder Treatment
- behavioral therapy
- self-instructed training
- antidepressant (Remeron) infrequently used to
treat agitation and sleeplessness
29Attention-Deficit Hyperactivity Disorder (ADHD)
- ADHD A condition of persistent inattention
leading to hyperactivity and impulsivity. - three subtypes of ADHD
- combined type (inattention and hyperactivity)
- predominately inattentive
- predominately hyperactivity-impulsive
30ADHD Symptoms
- these symptoms usually present before age 7
- difficulty sustaining attention and completing
tasks (attention deficit) - the inability to sit quietly without fidgeting or
squirming (hyperactivity) - (impulsivity) impatience and frequent
interruptions (impulsivity)
31ADHD Diagnosis
- criteria for diagnosis based on observation of
behavior and evaluation - inattention longer than 6 months and in at least
two of the following settings - home
- school
- work
- social activities
- behavior significantly impairs functioning
- symptoms must be present by age 7
32ADHD Treatment
- drug therapy
- amphetamines (Ritalin, Adderall XR)
- behavioral therapy
33Oppositional Defiant Disorder (ODD)
- ODD A behavior disorder in which children
demonstrate behaviors that are oppositional
toward adults. - The presence of ODD is a strong predictor of poor
outcomes such as early substance abuse, school
dropout, and major depression.
34ODD Symptoms
- is argumentative (especially with adults)
- refuses to comply with rules
- deliberately annoys others
- blames others for mistakes
- is angry/resentful
- is irritable
- is vindictive
35ODD Causes
- negative child temperament and ADHD
- negative parent temperament
- ineffective child management
- parent and family stress events
36ODD Treatment
- mood stabilizers (Risperdal, Zyprexa)
- parent training
- individual psychotherapy for child
37Tic Disorders
- Tic disorders Sudden, recurrent motor movement
(facial grimacing, coughing, eye blinking) or
vocalizations (repetition of ones own words,
using words out of context or in a socially
unacceptable manner).
38Tourette Disorder
- Tourette disorder Consists of multiple motor
tics coupled with one or more vocal tics, which
can appear simultaneously or at different times. - also known as Gilles de la Tourette syndrome
39Tourette Disorder Symptoms
- vocal tics
- clicks
- grunts
- yelps
- barks
- snorts
- obscenities
40Tourette Disorder Diagnosis
- Both motor and vocal tics are present, although
not necessarily at the same time. - Tics occur several times a day over a period of
at least 3 months. - The patient has significant impairment in
functioning at work or in social situations. - The condition is not a result of substance abuse
or another medical condition.
41Tourette Disorder Treatment
- Some patients improve with medication (Haldol,
clonidine) to manage symptoms and/or produce calm.
42Chapter 14 Lesson 14.2
43Dementia
- Dementia A progressive deterioration of mental
faculties that causes cognitive decline. - Irreversible brain damage may be the result of
compromised blood flow to the brain caused by
plaque in the arteries (atherosclerosis), blood
clot (thombus), or trauma.
44Alzheimer Disease
- Alzheimer disease A progressive degenerative
disease of the brain that causes a gradual loss
of mental and physical functioning. - It is the most common cause of dementia and
occurs more frequently in adults over 65 years of
age.
45Alzheimer Disease Symptoms
- early stage
- loss of short-term memory
- inability to concentrate
- impairment of reasoning
- subtle changes in personality
- as progression continues
- communication skills decline
46Alzheimer Disease Symptoms (contd.)
- late stage
- becomes increasingly dependent for care
- response to outside stimulus decreases
- becomes emotionally detached
- becomes restless
- suffers sleep disturbances
- becomes disorientated
- becomes hostile/combative
47Alzheimer Disease Cause
- The cause is not known, but it is suspected to be
age-related and have a genetic link. - theories include
- biochemical changes in brain growth
- autoimmune reaction
- infection with a slow-acting virus
- blood vessel defects
- deficiency of neurochemical factors in the brain
48Alzheimer Disease Diagnosis
- Diagnostic criteria include evidence of memory
and cognitive disturbances. - As the disease progresses, neurological
examination reveals sensory and motor deficits. - In later stages, diagnostic studies include brain
scans, which can detect atrophy.
49Alzheimer Disease Diagnosis (cont'd.)
50Alzheimer Disease Treatment
- No cure is known.
- Treatment is geared toward management of symptoms
and includes - drug therapy to help control cognitive decline,
anxiety, depression, and delusions - general management of fluid intake, adequate
nutrition, and personal hygiene - protection against injury
- emotional support for patient and caregiver(s)
51Vascular Dementia
- Vascular Dementia A reduction in blood flow to
the brain from narrowed arteries can result in
reduced oxygen and nourishment to the brain cells
and cause a general loss of intellectual
abilities.
52Vascular Dementia Symptoms
- Changes include disturbances in
- memory
- judgment
- abstract thinking
- personality
- apathy
- disorientation
- depression
- restlessness
- psychotic tendencies as condition progresses
53Vascular Dementia Cause
- Atherosclerotic plaque grows in the carotid and
cerebral arteries, reducing blood flow to brain. - This starves the brain for needed oxygen.
- Brain cells die, impairing cognitive function.
54Vascular Dementia Treatment
- to increase blood supply to the brain by means
of - drug therapy (low-dose aspirin, Plavix)
- surgical intervention to remove plaque from
carotid arteries
55Dementia Caused by Head Trauma
- Dementia caused by head trauma A traumatic
insult to the head may reduce blood flow to the
brain and result in dementia. - Type of head injuries that could reduce blood
flow include - open and closed head injuries
- hematomas (localized swelling filled with blood
resulting from a break in a blood vessel) - skull fractures
56Dementia Caused by Head Trauma Diagnosis
- physical and neurological examination
- imaging studies
- skull radiographic films
- CT scan of brain
- MRI scan of brain and cerebral vessels
57Dementia Caused by Head Trauma Treatment
- correction
- reduce intracranial pressure
- repair vessel damage
- therapy and training to retain the remaining
functions
58Substance-Related Disorders Alcohol Abuse
- Alcohol abuse A disorder causing physical and
psychological dependence through daily and
excessive use of alcoholic beverages. - Excessive use is often associated with anxiety,
depression, insomnia, impotence, and behavior
disorders.
59Alcohol Abuse Symptoms
- social (family disruption, violence, accidents,
etc.) - physical
- frequent infections
- hypertension
- gastrointestinal problems
- seizures
- alcohol withdrawal problems
- prolonged use may cause
- cirrhosis of liver
- pancreatitis
- peripheral neuropathy
- risk of cancer (esophagus, stomach, and parts of
GI tract)
60Alcohol Abuse Diagnosis
- screening tests
- physical examination (includes medical history)
- blood test shows high level of an enzyme called
gamma-glutamyltransferase or GGT
61Alcohol Abuse Treatment
- detoxification
- psychotherapy
- group therapy and/or 12-step program (AA)
- Antabuse causes violent nausea and vomiting when
alcohol is consumed.
62Other Drugs of Abuse
- Many types of drugs can modify mood or behavior
and possibly harm the body when abused. - The main classifications of drugs include
- stimulants (amphetamines, ecstasy, cocaine)
- opiates (heroin)
- hallucinogens (LSD)
- volatile substance (inhalants, vapors)
- cannabanoid (marijuana, hash)
- steroidal (steroids)
- tobacco
- prescription drugs
63Other Drugs of Abuse (contd.)
- general treatment guidelines
- must meet individuals needs and be tailored to
drug of abuse - individual should have a medical, psychological,
and social assessment - behavior therapy and adequate support crucial for
recovery and abstinence
64Schizophrenia
- Schizophrenia Any of a group of psychotic
disorders usually characterized by withdrawal
from reality, illogical patterns of thinking,
delusions, and hallucinations, and accompanied in
varying degrees by other emotional, behavioral,
or intellectual disturbances.
65Schizophrenia Symptoms
- classified in two ways
- positive manifestations an excess or distortion
of normal functioning - negative manifestations a loss of normal
functioning
66Schizophrenia Symptoms (contd.)
- positive
- delusions
- hallucinations
- disorganized speech
- catatonic behavior (bizarre posturing rigid)
- negative
- flat affect (no emotional expression)
- inability to speak (alogia)
- inability to make choices
67Schizophrenia Symptoms (contd.)
- early stage
- withdrawal or isolation
- disheveled appearance
- loss of interest school or work
- confusion
- anxiety/fear
- active phase
- marked social and occupational dysfunction
68Schizophrenia Diagnosis
- psychological tests (MMPI and some projective
tests) - brain scans (PET, FMR, MEG)
69Schizophrenia Treatment
- acute phase
- antipsychotic drugs
- long-term multidimensional treatment combines
- supportive psychotherapy
- drugs
- family involvement
70Mood Disorders Bipolar Disorder
- Bipolar disorder A major affective disorder with
abnormally intense mood swings from a
hyperactive, or manic, state to a depressive
syndrome.
71Bipolar Disorder Symptoms
- during manic episodes
- rapid speech
- frequent changes of topic
- minimal sleep
- excessive amount of energy
- impulsive choices
- delusions or auditory hallucinations possible
72Bipolar Disorder Symptoms (contd.)
- during depressive episodes
- sad or indifferent mood
- slow thoughts and speech
- avoid communication
- loss of interest in life
- loss of appetite
- sleep disturbance
- feelings of guilt
- threatened or attempted suicide
73Bipolar Disorder Treatment
- drug therapy
- Lithium carbonate is the drug of choice during an
acute phase. - Depakote and Tegretol are add-on drugs that may
help stabilize manic episodes. - antidepressants
- psychotherapy to encourage personal
responsibility, set goals, and establish limits
74Major Depressive Disorder
- Major depressive disorder A mood disorder
characterized by one or more serious depressive
episodes that include deep and persistent
sadness, despair, and hopelessness.
75Major Depressive Disorder Symptoms
- empty or heavy feeling inside
- vague sense of loss
- self-blame
- remorse
- guilt
- loss of self-esteem
- sleep disturbance (insomnia or hypersomnia)
- loss of concentration and interest in activities
- social withdrawal
76Major Depressive Disorder Diagnosis
- Medical and psychological assessments are needed.
- It is important to distinguish between reactive
depression, which results from a difficult or
stressful life experience, and MDD. - Depressive mood must be prominent and persistent
for a period of at least two weeks with at least
four of the previously mentioned symptoms.
77Major Depressive Disorder Treatment
- antidepressants
- psychotherapy
- electroconvulsive therapy
- family support and education
78Chapter 14 Lesson 14.3
79Anxiety Disorders
- Anxiety disorder Anxiety moves from the realm of
normal to abnormal when it persists and
prevents the person from leading a normal life. - Four classifications of anxiety disorders
- generalized anxiety disorder
- panic disorder
- phobic disorder
- obsessive-compulsive disorder
80Generalized Anxiety Disorder
- Generalized anxiety disorder a constant state
of anxiety about most things. - not situation-specific
81Generalized Anxiety Disorder Symptoms
- avoids making decisions or worries about ones
that have been made - panic attacks
- physiologic symptoms might include
- diarrhea
- elevated blood pressure
- sustained muscular tension
- inability to sleep nightmares common
82Panic Disorder
- Panic disorder Anxiety begins suddenly and
unexpectedly, reaching a peak within 10 minutes. - The attack is often accompanied by a sense of
impending doom, going crazy, losing control, or
dying.
83Panic Disorder Symptoms
- heart pounding
- rapid pulse
- sweating
- trembling
- shortness of breath
- chest pain
- nausea
- dizziness
- hot flashes
84Phobic Disorder
- Phobic disorder Marked by excessive, persistent,
and irrational fear and the avoidance of phobic
stimulus. - The source of anxiety can be an object or
situation, but it poses no actual danger.
85Obsessive-Compulsive Disorder (OCD)
- Obsessive-compulsive disorder Marked by
obsessions (persistent intrusions of unwanted
thoughts) and compulsions (uncontrollable urges
to carry out certain action). - Both features usually occur together, but not
always.
86Obsessive-Compulsive Disorder Symptoms
- common obsessions
- harming others
- suicide
- performing immoral sexual acts
- common compulsions
- excessive hand washing
- repeatedly checking door locks
87Obsessive-Compulsive Disorder Treatment
- psychotherapy
- hypnosis
- biofeedback
- relaxation therapies
- exercise
- antidepressants (SSRIs)
- hospitalization in severe cases
88Posttraumatic Stress Disorder (PTSD)
- PTSD A delayed response to an external traumatic
event that produces symptoms of extreme stress. - PTSD differs from other anxiety disorders because
the cause of the stress is an external event of
an overwhelmingly painful nature.
89PTSD Symptoms
- painful recollections
- nightmares
- insomnia
- irritability
90PTSD Cause
- PTSD caused by human actions (rape, acts of war,
abuse) tends to precipitate more severe reactions
than PTSD caused by natural disasters
(hurricanes, floods, earthquakes).
91PTSD Diagnosis
- distressing recollections of the event
- recurrent dreams and flashbacks
- avoidance of stimuli associated with the
traumatic experience - hyperarousal (rapid heartbeat, panic) when
thinking about or exposed to stimuli related to
event
92PTSD Treatment
- centers on restoring individuals sense of
control - counseling (helps victims accept the overwhelming
memories instead of avoid them) - drug therapy (antianxiety, antidepressants, or
medications to aid sleep)
93Somatoform Disorders
- Somatoform disorders A group of mental disorders
in which the person experiences physical symptoms
without the underlying organic cause. - Symptoms are real to the affected person and not
feigned. - No confirmed, diagnosable, medical condition
accounts for the symptoms of somatoform disorders.
94Somatization Disorder
- Somatization disorder, also known as Briquet
syndrome, consists of a number of recurring
somatic symptoms that have no underlying clinical
basis. - The symptoms appear before the age of 30 and
continue for several years.
95Somatization Disorder Symptoms and Diagnosis
- presence of four pain symptoms anywhere in the
body - two GI symptoms (nausea, vomiting, blood in
stool) without presence of pain - one sexual or reproductive symptom
- one neurologic symptom
- clinical basis for symptoms
96Somatization Disorder Treatment
- psychotherapy that includes behavior modification
- prognosis for cure very poor.
97Conversion Disorder
- Conversion disorder When anxiety is too
difficult to face, it may be unconsciously
converted to a physical or somatic symptom to
allow the person to escape or avoid the
situation. - Usually precipitated by a highly stressful
situation.
98Conversion Disorder Symptoms
- deficits in voluntary motor functions (paralysis,
tremor, tics) - sensory symptoms (oversensitivity to pain, touch,
or sound) - speech disturbances (loss of voice)
- physical symptoms (headaches, difficulty
swallowing or breathing, choking, etc.)
99Conversion Disorder Treatment
- psychotherapy
- hypnosis
- The course of the disorder is usually short, and
recurrence is common.
100Pain Disorder
- Pain disorder Manifested by pain that causes
significant distress and physical and social
impairment to such a degree that it takes control
of the persons life.
101Pain Disorder Symptoms
- severe and lasting pain (can be associated with
musculoskeletal disorders, neuropathies, and
malignancies) - condition not intentionally produced
102Pain Disorder Treatment
- underlying clinical conditions identified and
addressed - psychotherapy
- relaxation techniques
- narcotics (if pain relief cannot be achieved any
other way)
103Hypochondriasis
- Hypochondriasis fear of having a serious
disease, even though medical causes cannot be
found to substantiate the fear.
104Hypochondriasis Symptoms
- preoccupation with illness
- abnormal fear of disease
- symptoms often described in vague terms
- typically last more than 6 months
105Hypochondriasis Treatment
- psychotherapy
- helps person live with symptoms or reframe them
in such a way that extreme conclusions are not
drawn
106Munchausen Syndrome
- Munchausen syndrome Considered a factitious
disorder occurs when people simulate symptoms of
illness, knowing they are not ill and they seek
medical attention as a way to draw attention to
themselves. -
- Malingering, or the feigning of symptoms for
financial or personal gain, is also a factitious
disorder.
107Munchausen Syndrome by Proxy
- Munchausen syndrome by proxy A parent projects
symptoms to the child (usually a preschooler),
which stimulates the illness in the child and
causes the child to present for treatment. - The parent denies any knowledge of the actual
cause and relates the symptoms to be GI,
genitourinary, or something else.
108Gender Identity Disorders
- Gender identity disorders Conditions in which
individuals feel a powerful connection with the
opposite sex and want to be the opposite sex. - Individuals believe their current gender roles
are inappropriate.
109Gender Identity Disorders Symptoms
- boys
- preoccupation with feminine activities (dressing
in female clothes, playing with dolls) - avoidance of competitive sports
- some remark they dont want male genitalia, but
rather female genitalia
110Gender Identity Disorders Symptoms (contd.)
- girls
- display a dislike for feminine attire and prefer
boy-type clothing and short hair - prefer boys as playmates
- engage in typically, male sports and games
- many remark they will eventually grow male
genitalia and do not want breasts
111Gender Identity Disorders Treatment
- psychotherapy (to help individuals either feel
more comfortable in their assigned sex or accept
the feelings they have) - hormonal or surgical intervention
112Sleep Disorders Insomnia
- Insomnia A disorder associated with having
difficulty falling or staying asleep. - As a result of poor or interrupted sleep, the
individual wakes feeling physically tired,
groggy, tense, irritable, and anxious.
113Insomnia (contd.)
- possible causes
- medical problem/pain
- time zone change or jet lag
- high altitudes
- stimulants (coffee, amphetamines, steroids,
alcohol, nicotine) - psychological causes (anxiety, stress, fear of
sleeplessness)
114Insomnia Diagnosis
- To be diagnosed with insomnia, the sleeplessness
must - have a duration of longer than 1 month
- interfere with normal functioning in social,
occupational, or other areas - Polysomnography, or the recording of physiologic
variables during sleep, might be used.
115Insomnia Treatment
- Identify and remove source of sleeplessness.
- Change lifestyle to relieve tension and reduce
stress. - Keep regular sleep schedule.
- Eliminate noise and disruptions.
- Use bedroom for sleeping only and not work.
- Avoid caffeine, nicotine, and stimulants late
afternoon and evening. - Avoid strenuous exercise several hours before
bedtime. - Use medications as last resort for short periods
to aid sleep.
116Parasomnias
- Parasomnias A group of sleep disorders that
include sleepwalking, night terrors, and
nightmares. - Parasomnias usually occur in children early in
the night.
117Parasomnias Causes
- possible genetic link
- developmental, psychological, and organic factors
- brain tumors or fevers
- lithium and certain other drugs
118Parasomnias Treatment
- Protection from injury is primary for the
sleepwalking person. - Minimizing exposure to terror (especially from
movies, television, etc.) reduces occurrence of
night terrors. - Adults can be treated with sleep medications.
119Narcolepsy
- Narcolepsy A chronic neurological condition in
which a person has an irresistible tendency to
sleep during the daytime for a few seconds to
half an hour. - This is usually precipitated by sedentary,
monotonous activity.
120Narcolepsy Treatment
- therapeutic naps
- establishing a normal night sleep pattern
- drug therapy (daytime stimulant to remain awake)
121Sleep Apnea
- Sleep apnea Intermittent short periods when
breathing ceases during sleep and can be
potentially life-threatening. - categorized as either
- obstructive, when air is unable to flow in or out
of the upper airway - central, when the brain does not send appropriate
messages to initiate the breathing process
122Sleep Apnea Causes
- obesity and hypertension
- nasal obstruction
- alcohol ingestion
- smoking-related bronchitis
- sleep deprivation
123Sleep Apnea Diagnosis
- Diagnosis begins with a sleep history.
- Onset is usually during middle age.
- Daytime sleepiness, sleep attacks, snoring, and
snorting episodes suggest sleep apnea. - Sleep lab studies help confirm breathing patterns
during sleep.
124Sleep Apnea Treatment
- weight loss
- underlying pathological conditions corrected
(nasal obstruction, etc.) - special appliances to continuously feed air or
keep airway open - avoidance of drugs that suppress CNS (sedative,
alcohol, nicotine) - surgery to remove portion of the uvula soft palate
125Personality Disorders
- Personality disorder A pattern of behavior that
deviates from societys norms and is typically
rooted in a persons thoughts about him-or
herself. - often produce chronic, ingrained, and maladaptive
behavior
126Personality Disorders Symptoms
- disordered patterns of relating, thinking, and
perceiving - impaired social and occupational performance
- might appear arrogant, shy, or blaming
127Personality Disorders
- Ten personality disorders categorized into three
clusters
Cluster C avoidant dependent obsessive-compulsive
Cluster A paranoid schizoid schizotypal Cluster
B antisocial borderline histrionic narcissistic
128Personality Disorders (contd.)
- Cluster A
- paranoid personality disorder
- no trust in others suspicious others intend to
hurt or exploit - schizoid personality disorder
- lacking emotional expression of pleasure or pain
seem indifferent and socially detached - schizotypal personality disorder
- similar to schizoid socially, but can have
paranoid tendencies superstitious, believing
others have magical control
129Personality Disorders (contd.)
- Cluster B
- antisocial personality disorder
- disregard others violates others rights,
aggressive, no remorse - borderline personality disorder
- unstable relationships and self-image, fears
rejection prone to be manipulative and to verbal
outburts - histrionic personality disorder
- overly dramatic needs to be center of attention
appears immature and dependent and seek approval
from others - narcissistic personality disorder
- displays an absorption with self and lacks
empathy for others
130Personality Disorders (contd.)
- Cluster C
- avoidant personality disorder
- avoids social situations for fear of criticism or
disapproval,views self as inept or inferior - dependent personality disorder
- pattern of excessive reliance on others, feels
reluctant to disagree for fear of losing support - obsessive personality disorder
- extreme concern with orderliness and control
131Personality Disorders Treatment
- depends on symptoms of particular disorder, but
usually includes - psychotherapy
- drug therapy (anxiety, depression)
- family therapy
- prognosis very poor overall due to degree that
traits are ingrained into individuals way of
living