Causes & Treatment of Mental Illness Flashcards
5 circles in first nations mental wellness (inward to outward)
(1) self responsibility; (2) balance; (3) respect, wisdom, responsibility, relationships; (4) land, community, family, nations; (5) social, environmental, cultural, economic
Balance circle in first nations mental wellness
pertains to the balance of mental, spiritual, physical, and emotional well-being; differs from western approaches that tend to be secular (disregards spirituality)
How do first nations approach their mental wellness circles?
(1) looking at wellness across the continuum; (2) cultural and traditional healing; (3) services must be appropriate to one’s needs e.g. family-centered, trauma-informed; (4) integrated services for a person’s whole needs; (5) local nation-based approaches
5 major western paradigms
biological, psychoanalytic, humanistic/existential, cognitive, learning/behavior
Biological paradigm
mental illnesses result from dysfunctional biological processes e.g. one’s biochemistry, behavioral genetics, or specific biological insults like concussions
Temperament
a genetically encoded characteristic that is expressed through personality and shapes how we interact with the world
Big 5 dimensions of temperament
OCEAN (openness, conscientiousness, extraversion, agreeableness, neuroticism)
5 important neurotransmitters
norepinephrine (excitatory), gamma aminobutyric acid or GABA (inhibitory), dopamine (motivation and reward), serotonin or 5-HT, glutamate (learning and memory)
Serotonin
regulates basic functions like mood, appetite, sleep, and impulse control
Classical freudian theory (psychoanalytic paradigm)
the structure of the mind comprises the id, ego, and superego
ID
unconscious and most primitive part of personality that satisfies basic urges for pleasure (e.g. food, warmth, sex)
Ego
the part of personality that deals with reality, helps satisfy the demands of the ID, and recognizes what’s needed in the world
Superego
the part of personality that acts as a conscience and guides the ego to discern between what’s right and wrong
8 defense mechanisms (Freud)
repression, rationalization, reaction formation, regression, sublimation, projection, denial, displacement
Defense mechanisms
unconscious strategies to protect the ego from distress
Repression
having an impulse to do something and not giving into it or burying the urge
Denial
experiencing a traumatic event and saying that it never happened
Projection
accusing another person feeling what you are feeling (e.g. I’m not mad, you’re mad!)
Displacement
transferring negative feelings from one person or thing to another
Rationalization
justifying or making excuses for one’s own bad behavior or feelings
Reaction formation
having a negative reaction to someone then unconsciously acting the opposite
Regression
going back to an earlier developmental state than your current state due to an unmanageable stressor (e.g. an 18 year old sucking their thumb)
Sublimation
finding a creative and harmless way of acting on a negative impulse
2 primary learning/conditioning processes
classical and operant conditioning
Positive reinforcement
strengthens a response or behavior by introducing a pleasant stimulus afterwards
Negative reinforcement
strengthening a response or behavior by removing an unpleasant stimulus (e.g. stopping an alarm clock, procrastinating)
Positive punishment
weakening a response or behavior by introducing an unpleasant stimulus
Negative punishment
weakening a response or behavior by removing a pleasant stimulus
Classical conditioning
forming an association between unrelated elements due to repeated pairing of stimuli; based on the “law of effect”
Law of Effect
behavior that has pleasant consequences increases that behavior while unpleasant consequences decreases that behavior
Mowrer’s two-factor theory
(1) classical conditioning: individual responds emotionally to a neutral stimulus; (2) operant conditioning: individual learns to avoid conditioned (previously neutral) stimulus
Cognitive paradigm
psychological disorders result from cognitive errors as people actively interpret situations, imposing meaning through perception, interpretation, judgement, memory, and reasoning
Schema
an organized network of accumulated knowledge on how the world works that guides interpretation of events
Cognitive explanation of depression
a self-fulfilling prophecy due to pessimism (i.e. thinking negatively of oneself leading to isolation and self-deprecation)
Cognitive explanation of social anxiety
jumping to conclusions without recognizing the facts
Humanistic/Existential paradigm
the core of human functioning is your inner, subjective experience
What does the humanistic/existential paradigm emphasize?
searching for meaning in life, using agency and taking responsibility for your choices and attitude, living according to your values, and positive growth
Social factors of the development of mental disorders
poverty (poor housing, unsafe conditions, disrupted social ties), parental stress (parental depression, family conflict, harsh parenting)
Cultural factors of the development of mental disorders
prejudice and discrimination on ethnicity/rage, SOGI (sexual orientation and gender identity), mental illness
What influences the decision to get treatment depending on culture?
the culture’s approach to mental health, immigration stress, limited accessibility of services (e.g. language barrier, lack of knowledge in community)
Biopsychosocial model
a unified model of understanding psychopathology that includes biological factors, psychological (cognitive/emotional) factors, social and cultural factors
Diathesis (diathesis-stress)
what makes you more likely to have a disorder; the predisposing cause or underlying vulnerability
Stress (diathesis-stress)
what causes a disorder; the precipitating cause or triggering circumstances
2 types of diathesis-stress models
interactive and additive
Protective factors
influences that modify a person’s response to stressors and help them manage
Resilience
ability to successfully adapt to very difficult circumstances (or stress) that comes from having protective factors
Genes vs Environment
genes are the inherited tendencies that create vulnerability for a disorder (most are polygenic) and get activated depending on the kind of environment one’s in (can override genetic influence)
What does a combination of low levels of 5-HT and chronic stressors lead to?
eating disorders, depression, substance use, aggression
Gene-environment correlation
an individual’s genotype (e.g. temperament) can shape their environment through their interactions with it and the responses they elicit from it
What are the rates of divorce for fraternal vs identical twins?
if a fraternal twin is divorced, the other twin has a 2x higher rate of divorce; if an identical twin is divorced, the other twin has a 6x higher rate of divorce
What is the underlying premise of treatment?
people can change in certain ways
3 kinds of biological therapy
psychopharmacology or medication (most common), ECT or shock therapy, TMS
2 types of psychotherapy
evidence-based (Western) and not evidence-based
Evidence-based psychotherapy
specific studies found that a treatment works to decrease symptoms of a disorder within controlled conditions (treatment group >= comparison or placebo group)
Medication for psychosis
antipsychotics (to decrease dopamine)
Medication for bipolar mood disorders
lithium (to increase GABA)
Medication for anxiety
benzodiazepines (to increase GABA)
Medication for depression
SSRIs (to increase serotonin)
5 types of evidence-based psychotherapy
behavioral, cognitive, cognitive-behavioral, humanistic, interpersonal therapy
Classical (Freudian) psychoanalysis
free association, analysis of dreams, transference, resistance
Psychoanalytically oriented psychotherapy
object-relations and attachment
Behavioral therapy
if you modify behavior, the feelings will follow e.g. exposure therapy, modeling (i.e. being a role model), reinforcement, behavioral activation; works well with anxiety disorders and depression
Cognitive therapy
thoughts cause feelings and moods, which influences behavior; examines distorted patterns of thinking then changes one’s interpretation
Cognitive-behavioral therapy (CBT)
incorporates both thoughts and behaviors (easier to change) in maintaining a disorder and moods; most widely practiced
Which disorders does CBT work well with?
anxiety, mild-moderate depression, conduct disorder, bulimia
3 component model of CBT
affect (feelings), behavior, and cognitions each affect each other
Humanistic therapy
client-centered (patient knows what’s best for them and therapist has to help them make that realization); uses motivational interviewing (active listening and open-ended questions) and gestalt therapy (encouraging self-awareness)
Interpersonal therapy (IPT)
eclectic (uses multiple paradigms) but structured; uses the therapist-client relationship to address how the client relates to others and change behaviors
Which disorders does IPT work with?
borderline personality disorder and depression
Disadvantages of minoritized groups in psychotherapy
they are less studied, use less services, and have little access to mental health professionals of the same cultural background (i.e. a good client-clinician match)
