NCMHCE Test Study Guide 100% Correct What are the specific tasks that should be devoted to an initial interview? In order of time that should be spent on them? - History of Violence - 30% Personal, Social and Character Pathology - 25% Chief Complaints - 15% Medical History - 15% Mental Status - 10% Diagnosis and Treatment Discussion - 5% Predispositions have been found in family histories of the following disorders: - Substance Use, Mood Disorders, Tics and Eating Disorders Some Diagnostic Assessment instruments for mood disorders include: - MMPI-2, the Beck Depression Inventory (BDI) For personality disorders a good diagnostic tool is: - the MCMI-III To monitor for client improvement in mood disorders use: - the Beck Depression Inventory, Burns Anxiety Inventory or the SASSI A good treatment approach for panic disorder has been proven to be: - CBT Two short acting anti-depressants that have had similar withdrawal symptoms as alcohol, narcotics, marijuana, anxiolytics and some muscle relaxants are: - Paxil and Effexor Bipolar Disorder rapid cycling has been linked to ____________. - Thyroid Abnormalities Two corticosteroids are: - Prednisone and Cortisone Corticosteroids can can cause what symptoms/disorders? - Can cause changes in mood and cognition, are generally dose related and can precipitate psychosis, hypomania, depression, cognitive and memory problems. Interferon (treatment for Hep C) has caused what disorder in 23% of patients? Depression Cold meds can cause atropine. What is atropine? - confusion, disorientation, agitation, hallucinations, and memory problems. Acne medicine (Isotrentinoin) can cause severe.... - depression and suicidal behavior. Cormorbid traits of Tourette's Syndrome. - Relatives of clients with Tourette's have a higher incidence of tics, OCD and ADHD.
Some disorders that have family predispositions are: - Tourette's, Eating Disorders, Tics, Alcoholism, ADHD The top scales used in mental health are: - MMPI-2, Wechsler Adult Intelligence Scale -R, Bender Gestalt, Sentence Completion. The top scales used with adolescents are: - Wechsler Intelligence Scales, Rorschach Ink Blot Test, Bender Gestalt, Sentence Completion What is the NEPSY-II? - Neuropsychology II assesses brain development in ages 3-16. Helps ID academic, social and behavioral difficulties, ADHD, PDD/autism spectrum disorder, language disorder, mathematics disorder and reading disorder. NOTE: prior to administering the NEPSY-II gather data on their lives, medical risk factors, demands placed on child at home What is the Bender Gestalt II? - It measures visual motor behavior in ages 4-85. What is the MCMII-III? - The Millon Clinical Multiaxial Inventory measures personality traits and psychopathology. Helps ID schizoid personality, avoidant personality, depressive personality, dependent personality, histrionic personality, narcissistic personality, antisocial personality, sadistic personality (aggressive), compulsive personality, negativistic personality (passive-aggressive), self-defeating personality (masochistic). AS WELL as schizotypal, borderline and paranoid. BDI-II - Beck Depression Inventory can be used in diagnosing panic disorder, schizophrenia and mood disorders. What is the SCLR-90? - Gives PRESUMPTIVE OR IMPRESSIONISTIC MARKERS about the characteristics of a disease or condition. It is used with people with eating disorders (bulimic), anxiety or depressive disorders, stress, suicidal behavior, somatization, interpersonal sensitivity, paranoid ideation, psychoticism, sleep disorders, AOD abuse, physical or sexual abuse and sexual dysfunction and sensitivity to drug vs. placebo. SASSI-3 - Self report and screens for substance dependent disorder SCID-I and SCID-II - A set of questions to be used in conjunction with the bipolar spectrum diagnostic scale. Measures mood episodes, psychotic symptoms and disorders, mood disorders, substance use disorders, anxiety, adjustment disorders. BSDS - Bipolar Spectrum Diagnostic Scale - identifies presence or absence of bipolar disorder. MDQ - Mood Disorder Questionnaire - easy SCREENING tool for detecting bipolar I or disorder. NOTE: It is NOT used for monitoring for improvement.
DAST and SMAST - Drug Abuse Screening Test (for drugs) and Short Michigan Alcoholism Test (for people with drinking problems) DES - Dissociative Experiences Scale is used in tandem with the SCID-D (for dissociative disorders WISC-IV and WPPSI-III - Wechsler Intelligence Scales for ages 6-16, the WPPSI is for age 2.5-7. CDI - Children's Depression Inventory is FOR PARENTS about their children for ages 7-17. RCMAS-2 - Revised Children's Manifest Anxiety Scale - most widely used questionnaire assesses type and level of anxiety in ages 6-19. Achenback system of Emprically Based Assessment (ASEBA) - for ages 6-18 measures affective, anxiety, somatic, ADH, oppositional defiant and conduct problems. Behavior Assessment System for Children - Used to evaluate behavior and self-perceptions of children - one for TEACHERS and one for PARENTS. Conners 3 - Parent, Teacher, Adolescent Forms - For ages 6-18. Short and long forms for each. IDs ADHD and late disorders. Intellectual Disability (in children) - I: Wechsler Intelligence Test and Stanford-Binet Scales DD: ADHD, Depressive & Bipolar Disorders, anxiety Tx: Behavior Modification for self injury, parent training and community based Tx and individual psychotherapy Autism Spectrum Disorder - I: Childhood Autism Rating Scale, Disorders Screening Test II, the Social Communication Questionnaire, Taylor and Jaspers's Social Skills Inventory DD: Specific learning difficulties, coordination disorders, medical conditions Tx: Behavioral, floor technique, the Pervasive Development Pivotal Response Training ADHD - I: Achenbach Child Behavior Checklist, Behavior Assessment System for Children, Conner's Rating Scale-R, Conner's Teacher Rating Scales. DD: OppDefi, Conduct Disorder Tx: Stimulant medications, parent training, counseling, behavioral targeted classroom intervention, social skills, intereferes with functioning in social, academic and occupational domains. Conduct Disorder (CD) - I: Achenbach Child Behavior Checklist and Behavior Assessment System DD: Antisocial personality disorder, specific learning disorders Tx: Problem-Solving Skill dysregulation, imulsivity social skills, anger management, parent management
Oppositional Defiant (OD) - I: Achenbach Child Behavior Checklist, Behavioral Assessment System, Conner's Teacher Rating Scales-R DD: Conduct Disorder, ADHD, anxiety/depression Tx:Problem-Solving Skills Training (PSST), Cognitive, Behavioral, Individual Therapy. Separation Ansiety (SAD) in children - I: Child's Depression Inventory, The Washington University Schedule for Affective Disorders and Schizophrenia, Young Mania Rating Scale DD: GAD, specific phobia Tx: Exposure Therapy (highly effective), Cognitive-Behavioral, Coping Cat Model Bipolar 1 (in children) - I: Child's Depression Inventory, The Washington University Schedule, Young Mania Rating Scale DD: Anxiety disorders, panic disorder Tx: CBT, Interpersonal Therapy, Combination family focused and CBT, psychoeducational and maybe DBT PTSD (in Children) - I: Trauma Symptom Checklist for Children, Beck Anxiety Inventory DD: Depressive, bipolar, anxiety, substance use Tx: CBT, Exposure Therapy, Emotion Focused Cognitive-Behavioral, Trauma Focused CBT Adjustment Disorder (6 types) - I: The SCAD DD: Most mental health disorders Tx: Crisis-Intervention Model - Relieving acute symptoms, brief psychodynamic psychotherapy Major Depressive Disorder - I: Beck Depression Inventory, Hamilton Rating Scale, SCID DD: Substance related disorders, panic disorder, OCD Tx: CBT, low level of social functioning perform best with interpersonal psychotherapy. New therapies are Behvioral Activation Therapy, CBT-1, Mindfulness, exercise, Vagus nerve therapy Persistent Depressive Disorder (dysthymic disorders) - I: Beck Depression Inventory, Steen Happiness Index DD: Anxiety Disorder and substance use disorders Tx: CBT, Interpersonal Therapy, Social Skills, Assertiveness and decision making Bipolar Disorder - I: SCID, The Treatment Attitudes Questionnaire, Bipolar 2 use the hypomania checklist 32 DD: Panic attack, social anxiety, ADHD, conduct disorder, impulse control, substance use, intermittent explosive, opp-defi Tx: Medication first line, family focused psycho-educational treatment, social rhythm therapy and CBT, group therapy during recovery Combination Tx: Family focused therapy, IPT with social rhythm therapy, and CBT. Also good are day treatment, group therapy, self-help groups, electroconvulsive therapy and Vagus Nerve stimulation.
Cyclothymic Disorder - I: Hypomanic Checklist DD: Substance related and sleep disorders Tx: IPF, FFT, regulating sleep, circadian rhhthms and social rhythm. career counseling, interpersonal skill development, group counseling. Immediate family often has bipolar or hx of being hypersensitive. ANXIETY DISORDERS - I: Beck Anxiety Inventory, Anxiety Disorders Interview Schedule and Structured Clinical Ethnicity: African Americans tend to use gratitude and religiosity more than Europeans. Panic disorder co-exists with sleep paralysis more frequently in African Americans (60%) than Caucasians (8%). Hispanic patients may experience uncontrollable behaviors. Cambodian refugees have a high incidence of Panic disorder with physical discomfort. Tx: DBT, Exposure therapy, acceptance-based therapy, group therapy, cultural factors. Panic Disorder - I: ADVIS - measures avoidance, severity of panic; Burns Anxiety Inventory DD: Anxiety disorders, agoraphobia, major deprsesion, bipolar disorder, alcohol use Tx: CBT, panic control therapy, ACT, SFIT, family support, group therapy & Systematic Desensitization Phobias - I: Beck Anxiety Inventory, Burns Anxiety Inventory Tx: Exposure-based as relaxation training, breathing retraining and paradoxical intention Agoraphobia - I: Beck Anxiety Inventory, Mobility Inventory for Agoraphobia, Agoraphobic Cognition Questionnaire DD: Anxiety disorders, panic disorder, social anxiety, depressive Tx: Panic Control Therapy (PCT) is well documented Social Anxiety Disorder - I: Fear of Negative Evaluation and Social Interaction Anxiety Scale, Achenbach for aged 6-18 or Revised Children's Manifest Anxiety Scale for 6-19 DD: Anxiety Disorders, Major Depressive Disorder, Substance Use disorder Tx: CBT, CBGT (group version), Exposure, cognitive restructuring, social skills training, relaxation, homework, role playing, mindfulness, attention training.. Obsessive-Compulsive - I: Yale-Brown Obsessive Compulsive Scale, Obsessive-Compulsive Inventory-Revised DD: Panic Disorder, social anxiety disorder, GAD, specific phobia, bipolar disorder, tic, body dysmorphic disorder, trichotillomania, excoriation, schizophrenia/schizoaffective Tx: Exposure, response prevention, cognitive approaches that focus on thinking, checking family PTSD - I: The Clinician Administered PTSD Scale, the PTSD Checklist, for children K-SADS PTSD section, Child Behavior Checklist, Childhood Trauma Questionnaire, Phsychometric Evaluation of the Children's Impact of Traumatic Events Scale-R. DD: Depressive, bipolar, anxiety and substance use disorders
Tx: Prolonged exposure therapy (BEST), Cognitive processing therapy (for sexual assault/traumatic brain injury), anxiety management training; EMDR, Group and family therapy, stress inoculation training. Generalized Anxiety Disorder - I: Beck Anxiety Inventory, The Penn State Worry Questionnaire Anxiety Disorders Interview Schedule DD: Anxiety Disorder, unipolar disorder Tx: CBT, affective therapy (AWARE), Alcohol Related - I: Rapid Alcohol Problems Screen, Michigan Alcoholism Screening Test, MAST, CAGE, Alcohol Use Disorders ID Test DD: Bipolar disorder, schizophrenia, antisocial PD Tx: Combined behavior interventions - motivation enhancement, cognitive therapy, social skills training, cognitive restructuring, relaxation training, stress management, 12 step, family therapy Feeding and Eating Disorders - I: Questionnaire on EAting and Weight Patterns - Revised, Eating disorder Examination Questionnaire DD: social phobia, OCD, generalized anxiety disorder, ptsd, schizophrenia Tx: multidisciplinary approach, CBT, DBT for bulimia, active comparison group therapy Anorexia Nervosa - I: Questionnaire on Eating and Weight Patterns -R DD: Bipolar, depressive and anxiety disorders, alcohol use disorder Tx: Multidisciplinary approach, CBT, DBT, group, transdiagnostic approach, psychotherapy and family therapy Bulimia Nervosa - I: DBT, CBT, focus on therapeutic alliance, reducing -ve effect, modifying eating behaviors. DD: Depressive Sx, bipolar nervosa, nervosa Tx: Manualized based CBT Tx is preferred and DBT for BED Female Sexual Interest/Arousal Disorder - I: The Sexual Interest and Desire Inventory Female, the Sexual Opinion Survey, Sexual Dysfunction Scale, Sexual Desire Invenotry, Early Sexual Experiences Checklist, Interview for sexual functioning DD: Depression, thyroid problems, anxiety, urinary incontinence, other medical probs, arthritis, irritable bowel disease Tx: Medication, couples and group therapy, 12 step program, sex addicts anonymous, sexual conpulsives anonymous and sex and love addicts. Dissociative Identity Disorder - I: No recommendations, includes social role, gender ID, sexuality and body DD: PTSD, depressive disorders, avoidant and BPD, conversion disorder, somatic symptom disorder, eating disorders, substance related disorders, OCD, sleep disorders Tx: No recommendations.
Sleep-Wake Disorders - I: Level 2 Sleep Disturbance Patient reported outcome Measurement Info system (PROMIS) short form. Epworth Sleepiness Scale, Sleep disorders questionnaire, Sleep condition indicator, the Composite Scale of Morningness, polysomnography Dx: insomnia, hypersomnolence, narcolepsy, breathing related sleep disorder, circadian rhythm, non rapid eye movement, rapid eye movement, nightmare disorder, RLS, substance induced sleep disorder Comorbidity: Depressive and anxiety disorders, autim, ADHD, panic, OCD, adjustment disorders, dissociative diorders, somatic symptom, feeding and eating disorders, stimulant use disorders Tx: psychopharmacology, CBT, bright light therapy, sleep education, sleep hygiene, sleep restriction, stimulus control, cognitive restructuring, paradoxical intention, relaxation, and relaxation therapy. Positional therapy (head elevated) can be recommended for sleep apnea. Somatization Symptom Disorder (Briquet's syndrome) - I: Anxiety Disorders Interview Schedule DD: Medical Issues, Anxiety and depressive disorders Tx: Affective CBT, Group and family therapy - depends on form (conversion, pain, hypochondriasis, body dysmorphic) Pain needs IPT-P (prevention) and CBT. Excoriation needs HRT. Factitious Disorder - I: Clinical Interview DD: None provided in DSM Tx: Nothing known to be effective; stress management Delirium - I: None suggested; mental status exam; neurology DD: None suggested perhaps acute stress disorder, malingering and factitious disorder other neurocognitive disorders Tx: Medical and neurological assessment, psychotherapy and medication, eliminate casual fators, medications causing side-effects, metabolic disorders Major or minor neurocognitive disorder (dementia) - I: Comprehensive medical and neurological assessment DD: Age related disease and delirium Tx: Support for caregivers All Personality Disorders - I: MCMI, MMPI, Structured Clinical Interview Dx: Borderline, paranoid and schizotypal (most dysfunctional), obsessive compulsive, dependent, histrionic, narcissistic and avoidant are least dysfunctional usually Tx: psychodynamic, cognitive-behavioral, DBT, mindfulness, mentalization-focused, schema therapy Paranoid PD - I: MCMI, MMPI, structured clinical interview
Tx: Little effectiveness studies available, individual Tx preferred, Cognitive therapy, (group therapy contraindicated) Schizoid PD - I: MCMI, MMPI, structured clinical interview Tx: Schema therapy, social and communication skills Schizotypal PD - I: MCMI, MMPI, Structured Clinical Interview Tx: Supportive, lengthy and slow, cognitive therapy, behavior therapy for speech patterns Antisocial PD - I: MCMI, MMPI, Structured Clinical Interview Tx: Individual therapy, structured and active approach to therapy, some support for reality based approach for anger mgmt, substance use disorder and social skills training. mentalization-based therapy and schema therapy hold promise. Behavior, reality and cognitive approaches are helpful. Borderline PD - I: MCMI, MMPI, Structured Clinical Interview Tx: DBT, mentalization based therapy, transference focused therapy, schema focused CBT, supportive psychotherapy, STEPP group therapy, group can be more effective than indiv. Histrionic PD - I: MCMI, MMPI, Structured Clinical Interview Tx: Long term individual psychotherapy, CBT is best, group therapy Narcissistic PD - I: MCMI, MMPI, Structured Clinical Interview Tx: Psychoanalytic, CB, group therapy IF all members are narcissistic and can tolerate exposure and -ve feedback Avoidant PD - I: MCMI, MMPI, Structured Clinical Interview Tx: Randomized and control trials effective for psychodynamic psychotherapy. Behavioral interventions, schema focused therapy, group therapy, family therapy Dependent PD - I: MCMI, MMPI, Structured Clinical Interview Tx: Psychodynamic, CBT, Schema therapy Obsessive-Compulsive PD - I:Dysfunctional Through Record (active log), MCMI, MMPI, Structured Clinical Interview Tx: Psychodynamic psychotherapy, little evidence for CBT Psychotic - I: Positive and Negative Syndromes Scales, Structured Interview for Psychotic Symptoms Tx: Behavioural and psychosocial therapies are preferred for schizophrenia along with antipsychotic meds Dissociative DID - I: Cambridge Depersonalization Scale, Structured Clinical Interview for Depersonalization and Derealization Spectrum Tx: Individual therapy and medication
Schizophrenia - I: Positive and Negative Syndromes Scales, Structured Interview for Psychotic Symptoms Tx: Medication and psychosocial intervention, behavioral therapy, skills training, social support, group therapy Schizoaffective - No evidence of best practices Acceptance Commitment Therapy (ACT) - Therapy that targets thoughts and combine acceptance, compassion and commitment to goals. Recognize and stop self-perpetuating and self-defeating emotional, cognitive and behavioral avoidance routines. Affective Therapy - 5 stage process to fight anxiety Behavior Activation Therapy (BAT) - Behavioral treatment to help depressed avoid urge to escape or engage in avoidance behaviors. Cognitive Processing Therapy (CPT) - Combines exposure therapy, anxiety management training and cognitive restructuring. Considered helpful in treating rape victims and survivors of sexual assault. Dialectical Behavior Therapy (DBT) - based on CBT, helps people that are suicidal, BPD, have eating disorders, antisocial and substance use combined with BPD. EMDR - pairs visual stimulation, kinesthetic stimulation/auditory stimulation with a focus on the traumatic memories. Mentalization-based Therapy (MBT) - psychodynamic approach and central to the therapy is attachment theory. It is a manualized approach. Helps change responses to abandonment fears, to reduce impulsivity, self-harming and suicidal behavior. Mindfulness-based Therapies - Focuses on present moment, meditation and relaxation techniques. Mindfulness-bases stress-reduction (MBSR) targets depression. Panic Control Theory (PCT) - A cognitive behavioral approach that targets mistaken beliefs about physical sensations. It is psychoeducational, relaxing, cognitively restructuring and uses intreroceptive exposure exercises shown to reduce PANIC ATTACKS. Pivotal Response Training (PRI) - home-based intervention used with autism. Similar to "Floor Time". Polyvagal Therory: Vagus Nerve Therapy (VNS) - A device is implanted in the chest and sends electrical impulses to the vagus nerve that will activate the brain that leads to improve in mood. Prolonged Exposure Therapy - Recommended for anxiety, depression, PTSD especially. Goal is to decrease distress re: trauma. [systematic desensitization]
Rapid Resolution Therapy - For Trauma Victims. Goal is to overcome the intrusive sensorimotor elements of the trauma. Transforms traumatic memory into a personal narrative. Schema Therapy - Reflect childhood states: abandonment, anger/impulsivity, primitive parent, and detached protector. Therapist probes four environmental contributors to maladaptive behaviors: unstable home environment, over punitive parents, emotional negation or deprivation and environment where child's needs are subjugated to needs of parents. Sensation-Focused Intensive Treatment (SFIT) - Treats panic and avoidance in a self-study format over 8 days. Tx includes exposure to the most feared situations without teaching techniques for reducing the anxiety. Transference-focused Therapy - eating disorders, alcohol and substance disorders with anger, emotional dysregulation and impulsivity as symptoms. Focus is on integrated anger as the core for borderline pathology. hyperhidrosis - increased sweating Be sure to get family history for the following disorders: - mood disorders (particularly bipolar), schizophrenia, anxiety disorders, AHDH, eating disorders, alcoholism and substance dependency.