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Mental Health Disorders: Symptoms, Diagnosis, and Nursing Interventions, Study Guides, Projects, Research of Psychiatry

Virginia State University (VSU)Psychiatry

A concise overview of common mental health disorders, including depression, anxiety, and schizophrenia. It outlines key symptoms, diagnostic criteria based on beck's cognitive triad, and nursing interventions. The document also covers risk assessment for suicide, communication strategies, medication classes (ssris, tcas, maois), and specific interventions for anxiety disorders like gad, ocd, and ptsd. Additionally, it differentiates between positive and negative symptoms of schizophrenia and discusses various phases of treatment and patient education. This resource is valuable for students and professionals in nursing and mental health fields, offering a structured approach to understanding and managing these complex conditions.

Typology: Study Guides, Projects, Research

2025/2026

Available from 09/19/2025

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Mental Health Exam 2 Study Guide
2 Study Guide
Mood:
Depression : A mood disorder that is widespread issue, ranking high among causes of disability.
Define common symptoms:
Depressed mood
, difficulty sleeping or excessive sleeping
, indecisiveness,
decrease ability to concentrate
, suicidal ideation, increase or decrease in motor activity
, inability to feel pleasure
, increase or decrease in weight of more than 5% of total body weight over 1
month. Beck’s Cognitive Triad
Aaron T. Beck, one of the early proponents of cognitive therapy, applied cognitive behavioral
theory to depression. Beck proposed that people acquire a psychological predisposition to
depression through early life experiences. These experiences contribute to negative, illogical,
and irrational thought processes that may remain dormant until they are activated during times of
stress (Beck & Rush, 1995).
Beck found that depressed people process information in negative ways, even in the midst of
positive factors that affect the person’s life. Beck believed that three automatic negative thoughts
—called Beck’s cognitive triad—are responsible for the development of depression:
1. A negative, self-deprecating view of self: “I really never do anything well; everyone else
seems smarter.”
2. A pessimistic view of the world: “Once you’re down, you can’t get up. Look around, poverty,
homelessness, sickness, war, and despair are every place you look.”
3. The belief that negative reinforcement (or no validation for the self) will continue: “It doesn’t
matter what you do; nothing ever gets better. I’ll be in this stupid job the rest of my life.”
The phrase automatic negative thoughts refers to thoughts that are repetitive, unintended, and not
readily controllable. This cognitive triad seems to be consistent in all types of depression,
regardless of clinical subtype.
The goal of CBT is to change the way a patient thinks, which will in turn help relieve the
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Mental Health Exam 2 Study Guide

2 Study Guide

Mood:

Depression: A mood disorder that is widespread issue, ranking high among causes of disability. Define common symptoms: Depressed mood , difficulty sleeping or excessive sleeping , indecisiveness, decrease ability to concentrate , suicidal ideation, increase or decrease in motor activity , inability to feel pleasure , increase or decrease in weight of more than 5% of total body weight over 1 month. Beck’s Cognitive Triad Aaron T. Beck, one of the early proponents of cognitive therapy, applied cognitive behavioral theory to depression. Beck proposed that people acquire a psychological predisposition to depression through early life experiences. These experiences contribute to negative, illogical, and irrational thought processes that may remain dormant until they are activated during times of stress (Beck & Rush, 1995). Beck found that depressed people process information in negative ways, even in the midst of positive factors that affect the person’s life. Beck believed that three automatic negative thoughts —called Beck’s cognitive triad—are responsible for the development of depression:

  1. A negative, self-deprecating view of self: “I really never do anything well; everyone else seems smarter.”
  2. A pessimistic view of the world: “Once you’re down, you can’t get up. Look around, poverty, homelessness, sickness, war, and despair are every place you look.”
  3. The belief that negative reinforcement (or no validation for the self) will continue: “It doesn’t matter what you do; nothing ever gets better. I’ll be in this stupid job the rest of my life.” The phrase automatic negative thoughts refers to thoughts that are repetitive, unintended, and not readily controllable. This cognitive triad seems to be consistent in all types of depression, regardless of clinical subtype. The goal of CBT is to change the way a patient thinks, which will in turn help relieve the

depressive syndrome. This is accomplished by assisting the patient in the following:

Powerlessness Ineffective coping Impaired social interaction Social isolation Risk for loneliness Imbalanced nutrition: less than body requirements Disturbed sleep pattern Constipation Sexual dysfunction Communication Interventions

  1. Help the patient question underlying assumptions and beliefs and consider alternate explanations to problems.
  2. Work with the patient to identify cognitive distortions that encourage negative self-appraisal. For example: a. Overgeneralizations b. Self-blame c. Mind reading d. Discounting of positive attributes
  3. Encourage activities that can raise self-esteem. Identify need for (a) problem-solving skills, (b) coping skills, and (c) assertiveness skills.
  4. Discuss physical activities the patient enjoys (e.g., running, weightlifting). Explain that initially 10 to 15 minutes a day 3 or 4 times a week has short-term benefits.
  5. Encourage formation of supportive relationships, such as through support groups, therapy, and peer support.
  6. Provide information referrals, when needed, for spiritual/religious information (e.g., readings, programs, tapes, community resources). Physical Interventions: Nutrition; Anorexia:
  7. Offer small, high-calorie, and high-protein snacks frequently throughout the day and evening.
  1. Offer high-protein and high-calorie fluids frequently throughout the day and evening.
  2. When possible, encourage family or friends to remain with the patient during meals.
  3. Ask the patient which foods or drinks he or she likes. Offer choices. Involve the dietitian.
  4. Weigh the patient weekly and observe the patient’s eating patterns. Sleep; Insomnia
  5. Provide periods of rest after activities.
  6. Encourage the patient to get up and dress and to stay out of bed during the day.
  7. Encourage the use of relaxation measures in the evening (e.g., tepid bath, warm milk).
  8. Reduce environmental and physical stimulants in the evening—provide decaffeinated coffee, soft lights, soft music, quiet activities. Self-care deficit:
  9. Encourage the use of toothbrush, washcloth, soap, makeup, shaving equipment, and so forth.
  10. When appropriate, give step-by-step reminders such as, “Wash the right side of your face, now the left.” Elimination-constipation
  11. Monitor intake and output, especially bowel movements.
  12. Offer foods high in fiber and provide periods of exercise.
  13. Encourage the intake of fluids.
  14. Evaluate the need for laxatives and enemas. Medications- Classes: SSRI, TCA, MAOIs
    • Make sure to know specific meds within each class

Anxiety: anxiety can be defined as a feeling of apprehension, uneasiness, uncertainty,

or dread resulting from a real or perceived threat whose actual source is unknown or unrecognized. Normal anxiety is a healthy life force that is necessary for survival. It provides the energy needed to carry out the tasks involved in living and striving toward goals. Acute anxiety is precipitated by an imminent loss or change that threatens an individual’s sense of security. Acute anxiety is a normal and expected response to stress.

Projection: Perceives and reacts to inner qualities as though outside the self. ex: Man who is unconsciously attracted to other women teases his wife about flirting. Displacement: Shifts an emotion one idea to another. ex: Patient criticizes a nurse after his family fails to visit. Rationalization: Offers rational explanation to justify attitudes, beliefs behaviors instinctually based. Ex: Employee says, “I didn’t get the raise because the boss doesn’t like me.” Humor: Person may focus and tolerate what is terrible to be borne. Wit, however, does not allow feeling of the effect Nursing Diagnosis associated with anxiety (Table 11-6) Ineffective coping Deficient diversional activity Social isolation Ineffective role performance Sleep deprivation Disturbed sleep pattern Fatigue Self-care deficit Outcomes for anxiety (Table 11-7) Generalized anxiety disorder Patients will:

  • State increased ability to make decisions and problem solve.
  • Demonstrate ability to perform usual tasks even though still moderately anxious (by date).
  • Demonstrate one cognitive or behavioral coping skill that helps reduce anxious feelings (by date). Obsessive-compulsive disorder Patients will:
  • Demonstrate techniques that can distract and distance self from thoughts that are anxiety producing (by date).
  • Decrease time spent in ritualistic behaviors.
  • Demonstrate increased amount of time spent with family and friends and on pleasurable activities.
  • State they have more control over intrusive thoughts and rituals (by date) Describe Post Traumatic Stress Syndrome- nursing diagnosis associated with PTSD Intrusive experiences; “flashbacks,” avoidance, and numbing SSRI antidepressants, buspirone augmentation of SSRI, second-generation antipsychotics Hyperarousal Antidepressants, benzodiazepines, α2-adrenergic agonists, anticonvulsants Transient psychosis, marked derealization Low-dose antipsychotics Nightmares; Prazosin (Minipress) Treatment-resistant PTSD; Second-generation antipsychotics, anticonvulsants Depression Antidepressants Panic attacks Antidepressants, MAO inhibitors, high-potency benzodiazepines Difference between Acute Stress Disorder and PTSD Acute stress disorder can occur after the same kind of triggers that exist in posttraumatic stress disorder, which include experiencing a violent event or repeatedly witnessing a violent or traumatic event (e.g., first responders at the scene of a mass casualty incident, police 127officers repeatedly exposed to details of child abuse). Possible precipitating traumatic events are the same as those listed under Posttraumatic Stress Disorder. However, in an acute stress disorder, the resolution of the symptoms is within 1 month. Medications for Anxiety
  1. Benzodiazepines: Prescribed for short-term treatment only; not recommended for use by patients with substance use problems. Benzodiazepines can be highly addictive and are prescribed for short periods of time, especially when used to self-medicate for anxiety/depression.
  2. Buspirone: Management of anxiety disorders; this medication is nonaddictive, an excellent medication for people needing long-term relief of anxiety symptoms (e.g., GAD).
  3. SSRIs: First-line treatment for all anxiety disorders, and OCD and BDD.
  4. SNRIs: Examples include venlafaxine, milnacipran, and duloxetine; only venlafaxine is currently approved for panic disorder (PD), generalized anxiety disorder (GAD), and social affective disorder (SAD).
  • Tangentiality
  • Incoherence
  • Illogicality
  • Circumstantiality
  • Pressure of speech
  • Distractible speech
  • Clang associations Negative: Include poverty of thought, loss of motivation, inability to experience pleasure or joy, feelings of emptiness, and blunted affect. Symptoms of Negative: Unchanging facial expression
  • Decreased spontaneous movements
  • Paucity of expressive gestures
  • Poor eye contact
  • Inappropriate affect
  • Lack of vocal inflections Describe alternations in speech: Flight of ideas- associative looseness Client may say sentence after sentence, but each sentence may relate to another topic, and listener is unable to follow the client’s thoughts. Neologisms-made up words that have meaning only to the client, such as, ‘’I tranged and flittled.’’ Echolalia: The client repeats the words spoken to him. Clang association-Meaningless rhyming of words, often forceful, such as oh fox, box, and lox. Word salad-word jumbled together with little meaning or significance to the listener, such as, Hip hooray, the flip is cast and wide-sprinting in the forest. Treatment focus during different phases (Table 17-5) Phase 1: Interventions are also geared toward the phase of schizophrenia (Table 17-5). During phase I the clinical focus is on crisis intervention, acute symptom stabilization (medication), and safety

Acute psychopharmacological treatment Limit setting Supportive and directive care Psychiatric, medical, neurological evaluation Meeting with family Psychosocial evaluation Linkage with:

  • Social services
  • Human services
  • Community treatment agencies Psychoeducational interventions with families Phase 2: Health teaching includes teaching:
  • Patient and family about the disease
  • Patient and family about medication management
  • Cognitive and social skills enhancement
  • Strategies to minimize stress and to control anxiety levels Support and teaching Medication teaching and side effect management Direct assistance with situational problems Identification of prodromal and acute symptoms and signs of relapse Continued psychoeducational work with families as needed Phase 3: Attention to details of self-care, social, and work functioning Direct intervention with family and/or employers Cognitive and social skills enhancement Medication maintenance