Table Of ContentC O N T E N T S
UNIT I FOUNDATIONS IN THEORY 19 Sleep-Wake Disorders, 364
20 Sexual Dysfunctions, Gender Dysphoria,
and Paraphilias, 380
1 Mental Health and Mental Illness, 1
21 Impulse Control Disorders, 400
2 Relevant Theories and Therapies for Nursing
22 Substance-Related and Addictive Disorders, 412
Practice, 19
23 Neurocognitive Disorders, 431
3 Biological Basis for Understanding Psychiatric
24 Personality Disorders, 457
Disorders and Treatments, 37
UNIT V TRAUMA INTERVENTIONS
UNIT II FOUNDATIONS FOR
PRACTICE
25 Suicide and Non-Suicidal Self-Injury, 480
26 Crisis and Disaster, 498
4 Settings for Psychiatric Care, 65
27 Anger, Aggression, and Violence, 515
5 Cultural Implications for Psychiatric Mental
28 Child, Older Adult, and Intimate Partner
Health Nursing, 83
Violence, 531
6 Legal and Ethical Guidelines for Safe Practice, 98
29 Sexual Assault, 552
UNIT III PSYCHOSOCIAL NURSING
UNIT VI INTERVENTIONS FOR
TOOLS
SPECIAL POPULATIONS
7 The Nursing Process and Standards of Care
30 Psychosocial Needs of the Older Adult, 565
for Psychiatric Mental Health Nursing, 115
31 Serious Mental Illness, 584
8 Therapeutic Relationships, 131
32 Forensic Psychiatric Nursing, 598
9 Communication and the Clinical Interview, 147
10 Understanding and Managing Responses
to Stress, 166 UNIT VII OTHER INTERVENTION
MODALITIES
UNIT IV PSYCHOBIOLOGICAL
33 Therapeutic Groups, 607
DISORDERS 34 Family Interventions, 619
35 Integrative Care, 636
11 Childhood and Neurodevelopmental
Disorders, 181 Appendix A DSM-5 Classification, 651
12 Schizophrenia and Schizophrenia Spectrum
Disorders, 200 Appendix B NANDA-I Nursing Diagnoses
13 Bipolar and Related Disorders, 227 2012-2014, 665
14 Depressive Disorders, 249
15 Anxiety and Obsessive-Compulsive Related Appendix C Historical Evolution of Psychiatric
Disorders, 278 Mental Health Nursing, 668
16 Trauma, Stressor-Related, and Dissociative
Disorders, 304 Glossary, 672
17 Somatic Symptom Disorders, 324
Index, 683
18 Feeding, Eating, and Elimination Disorders, 343
VARCAROLIS’
Foundations
of Psychiatric Mental
Health Nursing
A CLINICAL APPROACH
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Margaret Jordan Halter,
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3251 Riverport Lane
St. Louis, Missouri 63043
VARCAROLIS’ FOUNDATIONS OF PSYCHIATRIC MENTAL ISBN: 978-1-4557-5358-1
HEALTH NURSING: A CLINICAL APPROACH
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Library of Congress Cataloging-in-Publication Data
Varcarolis’ foundations of psychiatric mental health nursing : a clinical approach. — 7th ed. / [edited by]
Margaret Jordan Halter.
p. ; cm.
Foundations of psychiatric mental health nursing
Rev. ed. of: Foundations of psychiatric mental health nursing / [edited by] Elizabeth M. Varcarolis,
Margaret Jordan Halter. 6th ed. c2010.
Includes bibliographical references and index.
ISBN 978-1-4557-5358-1 (pbk. : alk. paper)
I. Halter, Margaret J. (Margaret Jordan) II. Varcarolis, Elizabeth M. III. Foundations of psychiatric mental
health nursing. IV. Title: Foundations of psychiatric mental health nursing.
[DNLM: 1. Mental Disorders—nursing. 2. Psychiatric Nursing. WY 160]
RC440
616.89’0231—dc23
2013012893
Senior Content Strategist: Yvonne Alexopoulos
Senior Content Development Specialist: Lisa P. Newton
Publishing Services Manager: Jeff Patterson
Senior Project Manager: Clay S. Broeker
Design Direction: Karen Pauls
Printed in the United States of America
Last digit is the print number: 9 8 7 6 5 4 3 2 1
In honor of my grandmother, Edith (1882-1927), who lost her life to depression
before hope of recovery existed.
1-in-128 odds for 7 female births in a row . . . to our dear daughters,
Elissa, Emily, and Monica, and their daughters, Kiran, Leela, Vivienne, and Violette.
My husband, Paul, is a loved man indeed!
And finally, to my twin sister, Anne. What a bonus in life.
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A C K N O W L E D G M E N T S
My ancestors were storytellers. Boxes of diaries, articles, news- my life goals, the profession, countless students, and recipients
paper clippings, and books in an unused closet detail many of of psychiatric mental health care. I wish for her all the best as
their moves and thoughts. The family tree includes a newspaper she enjoys retirement with her husband, Paul.
editor, a historian, a poet, and a nonfiction writer. One great My heartfelt appreciation also goes out to the talented group
aunt, Ella Chalfant, published a book titled A Goodly Heritage of writers who contributed to the seventh edition. This was an
in 1955 and was likely an early feminist. Her book centered on especially challenging version since the publication year was
inheritance laws in the 1800s and featured copies of wills that the same as for the Diagnostic and Statistical Manual’s fifth
demonstrated the disenfranchisement of women (e.g., a hus- edition. Clinical chapters were rearranged, and content was
band needed to leave a wife’s clothing to her on his death). As a added and deleted. My particular thanks go to those contribu-
registered nurse, I did have the opportunity to write some sto- tors who created new chapters and incorporated new content.
ries (in the form of nurses notes); as a tenure-track faculty I have a talented pool of veteran writers, and their knowl-
member, I was required to write some stories (in the form of edge and passion continue to influence psychiatric nursing
presentations and publications). in this edition. I have also welcomed a new cohort of writers
A 2004 phone call finally put me on the path to more fully whose expertise was both recognized and sought. It has truly
join these relatives in their vocation. I was in my office when been a joy working with each of you. Thanks for the countless
the phone rang. A pleasant voice with a slight New York accent hours you spent researching, writing, and rewriting!
says, “Peggy? Hi, this is Betsy Varcarolis.” I knew the name at A huge debt of gratitude goes to the many educators and
once. She went on, “The reason I’m calling is that I very much clinicians who reviewed the manuscript and offered valuable
enjoyed your article, “Stigma and help seeking related to suggestions, ideas, opinions, and criticisms. All comments were
depression: A study of nursing students.” I would like to feature appreciated and helped refine and strengthen the individual
it as an Evidence-Based Practice box in the fifth edition of my chapters.
book.” I was thrilled—what an honor! Throughout this project, a number of people at Elsevier
This was the beginning. After that call, my work progressed provided superb support. Sincere thanks go to Clay Broeker,
from chapter reviewer to chapter writer to textbook editor. I my gracious project manager, and to Karen Pauls, a talented
accomplished these milestones as an apprentice of Elizabeth and creative designer. Special gratitude goes to the team who
Varcarolis, the genius who conceived and published the first got this project off the ground and kept it airborne for nearly
edition of Foundations of Psychiatric Mental Health Nursing in 2 years. Yvonne Alexopoulos, senior content strategist, kept
1990 and went on to make this textbook a leader in the specialty me on a straight path; Lisa Newton, senior content develop-
of psychiatric nursing. Betsy has the rare gift of making the ment specialist, was my ever-optimistic team member who
complex understandable and of making impersonal learning a celebrated each milestone; and Kit Blanke (Mr. Kit Blanke),
joint process in which the experts talk with the students rather content coordinator, helped keep me organized and up to
than just providing information. speed on technological advances. My sincere thanks go out to
In this seventh edition of the book, Elizabeth Varcarolis is the whole Elsevier team.
honored with her name being added to the title. My sincere
thanks and gratitude go out to Betsy for what she has done for Peggy Halter
vii
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