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PSYCH 329: Adult Development and Aging > Ch.6: Mental Health and Mental Health Disorders > Flashcards

Ch.6: Mental Health and Mental Health Disorders Flashcards

1
Q

What is Assessment?

A
  • It is a systematic approach to assessing behavior, cognition, or emotion; ideally it is multidimensional, using interview, standardized measures, self-and family report
  • Assessment is an essential first step in developing an appropriate treatment plan
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2
Q

What are 5 assessment measures?

A
  1. Mental status examination- assesses current state of mind
  2. Functional abilities- ADLs and IADLs
  3. Clinical interview- questions in face-to-faced setting somewhat flexible. In order to be able to truly assess somebody, you want to get an idea of a person’s real abilities & what is their insight
  4. Physical examination- rule out underlying physical reasons for emotions, thinking or behavior
  5. Specific symptom measures- Geriatric Depression Scale
    Older people have different presentations of depression than younger people do.
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3
Q

Issues in assessing older adults to avoid systematic errors in the assessment process: (3)

A
  • Assessment should be tailored to older adults (ex: geriatric depression scale)
  • Need to account for sensory (glasses, hearing aids), motor, and cognitive limitations
  • Biases/stereotypes (ex: assuming a person’s first language is English)
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4
Q

Myth: aging leads to depression- old age is depressing
What is the reality?

A

Reality: rates for major depression are lower in the elderly compared to younger adults

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5
Q

__________ impairment is a positive symptom of major depressive disorder

A

Memory

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6
Q

Patten and his colleagues (2015) used data from the Canadian Community Health Survey to examine the last-year prevalence rate of depression in a household sample of 25,113 Canadians.
What did they find out?

A

Depression is not as prevalent in the older age groups as it is in the young and middle-aged groups/

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7
Q

Why are there lower levels of depression for older adults living in the community?

A
  1. Older adults may not be correctly diagnosed for major depressive disorder
    - Health care professionals may not be trained in diagnosis of older adults
    - Older adults may not accurately report symptoms. They might label their feelings as pessimism or hopelessness instead of labeling their feelings as depression
    - Physicians spend too little time with them
    - Reimbursement rates lower than for medical
    - Attitudes toward depression in older adults
    - Medical and psychological symptoms may co-occur
  2. Sub-syndromal depressive symptoms (depressive symptom that don’t meet the DSM 5 criteria) may also be more prevalent in older versus younger adults
  3. Older adults may be better at regulating their emotions and thus report fewer depressive symptoms
    - Older adults generally experience less stress than those whoa re younger, and tend to use emotion-focused coping rather than problem-focused coping, and may therefore be better at regulating their emotions
    Emotional regulation gets better with age=not seeking help
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8
Q

Treatment for depression

A
  • Selective serotonin reuptake inhibitors (SSRIs) =first medication of choice for olde people depression
  • Electroconvulsive therapy (ECT)- If SSRIs aren’t working
  • Cognitive-behavior therapy, problem-solving therapy, and interpersonal psychotherapy
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9
Q

What works best in treating depression?

A

A combination of drugs and therapy

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10
Q

What are some considerations for older adults in SSRI treatment?

A
  • take precautions against drug interactions
  • may have serious side effects including addiction
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11
Q

What is a consideration for older adults in ECT treatment?

A
  • may cause short-term memory loss
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12
Q

What is a consideration for older adults when it comes to therapies?

A
  • need to tailor the therapies to older adults= can take a slower pace, shorter sessions, etc.
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13
Q

Pseudodementia

A
  • looks like dementia (because of the memory loss that comes with aging) but it is depression masked as dementia
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14
Q

Distinguishing between Pseudodementia and Dementia

A
  • Pseudodementia patients have a more abrupt onset of cognitive symptoms while there is an insidious onset (years) of irreversible dementia
  • Pseudodementia patients realize they memory trouble (are frustrated and will say I don’t know on memory tests) while people with irreversible dementia do not recognize/acknowledge their memory problems even while struggling to give correct answers (more likely to conceal memory difficulties)
  • Pseudodementia patients score relatively higher in levels of depression while patients with dementia often show a wide range of emotions, sometimes responding to situations with an inappropriate emotion (such as laughing when others are grim)
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15
Q

SPECT imaging

A
  • important to reveal the underlying cause of symptoms since the treatment for depression.
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16
Q

Features that distinguish depression from bereavement. Depression more likely to involve:

A
  • guilt
  • suicidal thoughts
  • morbid preoccupation with worthlessness
  • psychomotor retardation
  • prolonged and marked functional impairment
  • complex hallucinations (not just thinking they heard voice of loved one, or transiently saw their image)
17
Q

Suicide attempts more common in ________________ than older adults

A

younger adults

18
Q

Factors associated with suicide in older adults

A
  • psychiatric and neurocognitive disorders-dementia
  • social exclusion
  • loneliness and bereavement
  • cognitive impairment, decision making and cognitive inhibition
  • physical illnesses
  • physical and psychological pain
19
Q

A significant portion of older adults who have died by suicide:

A

Had recently visited their doctor but have not seek mental health treatment

20
Q

Used to be thought that anxiety disorders decreased with age. But now, it doesn’t.
What is true about anxiety and older adults?

A

Anxiety is just as common in older adults as it is in younger adults

21
Q

Generalized anxiety disorder (GAD)

A
  • most common anxiety disorder
  • characterized by persistent and excessive worry
  • the prevalence of GAD has been found to be twice as high in older adults as compared to the prevalence in younger clinical samples
  • almost half of older adults have the first onset of GAD after age 50
  • rates are higher in women than in men
22
Q

Difficulty assessing anxiety disorders in olde adults

A
  • A lack of age-appropriate anxiety measures is a major issue.
    The things that middle-age people worry about are different than the type of things that older adults worry about
  • Anxiety can also be masked by comorbid medical conditions (e.g., cardiovascular disease, arthritis, migraine headaches, lung disease, and gastrointestinal problems), as well as medication side-effects
  • Older adults are sometimes more likely to report physical symptoms and more reluctant to report psychological symptoms
23
Q

Medical treatment for Anxiety Disorders

A

Selective serotonin reuptake inhibitors (SSRIs)- a type of anti-depressant, are also the treatment of choice for both short- and long-term treatment of anxiety disorders

24
Q

Non-Pharmacological treatments for Anxiety Disorders

A
  • Cognitive-behavior therapy (CBT) - there’s internet-based CBT now
  • supportive discussion groups, relaxation therapy, and worry groups also have some evidence
25
Q

Criteria for Substance Abuse Disorders

A
  • cravings to use the substance
  • wanting to cut down or stop but not managing to
  • taking the substance in larger amounts or for longer than you’re meant to
  • neglecting other parts of your life because of substance use
  • continuing to use, even when it causes problems in relationship
  • using substances even when it puts you in danger
26
Q

Do older adults go to treatment programs?

A

No, they don’t

27
Q

The same drug that you’ve been using for a long time can start to impact you in a different way because of ____________ and _______________

A

pharmacodynamics and pharmacokinetics

28
Q

“Benevolent ageism” by Susan Lehmann

A

physicians may worry about being perceived as disrespectful if they confront older patients about potential substance abuse

29
Q

While data suggest that older adults do not have higher rates of alcohol use, this is changing with:

A

baby boomers’ positive attitudes toward alcohol.

Moreover, moderate alcohol consumption is part of the Mediterranean diet, which is becoming more popular for overall health

30
Q

Alcohol abuse can be _______________ or ______________

A

early onset (prior to 60) (has poorer outcome)

late onset (after 60) (1/3 of people)

31
Q

Tailoring

A

refers to the process of making treatments appropriate to certain groups, such as older adults.

32
Q

TRUE or FALSE

Evidence suggests that older adults do better in treatment programs that involve age-appropriate care with healthcare professionals who are knowledgeable about aging issues, and take the treatment at a slower pace

A

TRUE

33
Q

Programs with evidence of success for treating substance-use disorders

A

Motivational interviewing, 12-step programs (e.g., AA), and cognitive-behavior therapy, particularly when developmentally appropriate, have promise in treating those with substance use disorders

34
Q

4 Barriers to mental health treatment

A
  1. Qualifications- it’s difficult to find someone qualifies to treatment because a lot of people just don’t have any specialty in geriatrics
  2. Transportation- getting to your treatment
  3. Cohort effects- you might think that your feelings are not useful & relevant
  4. Cost of treatment- very expensive
35
Q

This provides clear guidelines for the training in provision of psychological services for older adults

A

Pikes Peak Model of Geropsychology

36
Q

TRUE or FALSE

mental health deteriorates in older adults

A

False, good things can and often do happen in old age

37
Q

TRUE or FALSE

Major depression is more frequent among the elderly than among younger people

A

FALSE

38
Q

TRUE or FALSE

Suicide is more frequent amongst adolescents than older adults

A

FALSE

39
Q

TRUE or FALSE

Older adults do not use or abuse mood-altering substances

A

FALSE

PSYCH 329: Adult Development and Aging (12 decks)

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