Clinical Psychology - Lecture 2: Understanding Mental Health Problems Flashcards

1
Q

Approaches to understanding MH problems

A
  • Medical model
  • Psychoanalytic/Psychodynamic – unconscious conflict
  • Behaviourism (learning theory)
  • Cognitive model -cognitive processes -> underlying beliefs about self and others in the world
  • Humanism – external environment impedes natural development - opportunities had to experience validation and empathy
  • Sociocultural model (emphasises social context) - various cultural models
  • Cultural models
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2
Q

The Medical Model

A
  • Focuses on physiological explanations
  • Borrows language from medicine
  • Genetic and neurological explanations - Genetic -> extent found in family members, Neurological -> brain imaging - looking at differences in brains of those with and w/out MH problems
  • Tends to ignore psychological and social explanations
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3
Q

Advantages of medical model

A
  • If it works, it often works quickly - compared to therapy/long-term processes
  • > often takes time for drug to reach therapeutic level for person
  • Avoids dealing with causes (which can be painful/difficult)
  • Cheaper
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4
Q

Disadvantages of medical model

A
  • Suggests problems are illness
  • Ignores psycho-social causes
  • Doesn’t help ppl to help themselves
  • Potential for adverse effects (e.g. side effects, addictions) -> MH deterioration
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5
Q

How can medication be helpful?

A

Can help ppl to be bought to space at which they can engage with psychologist

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6
Q

Psychoanalytics/psychodynamic approaches

A
  • Psychological difficulties understood as conflicts between different parts of the psyche (Id, Ego, Superego)
  • Most conflicts relate to early experiences in relationships with attachment figures
  • Early relationships with attachment figures
    form a blue-print for later relationships
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7
Q

Id

A

Immediate radification

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8
Q

Superego

A

Impose moral compass

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9
Q

Ego

A

Balance above superego and Id

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10
Q

Different parts of psyche when using the psychoanalytics/psychodynamic approach

A

Trying to make these parts of the psyche more conscious for person

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11
Q

Blue-print for relationship

A

When see secure attachment between adults/caregivers and kids -> grow up to be secure attachment styles as adults
-> What happens when young has huge impact on how we relate to others as adults

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12
Q

Psychodynamic therapy

A
  • Originated with Freud in the early 1900s, substantially transformed since
  • Focuses on psychological roots of emotional suffering
  • Hallmarks in self-reflection and self-examination, and the use of the relationship between therapist and patient as a window into problematic relationship patterns in the patient’s life.
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13
Q

What can unconscious competing demands do?

A

Create Psychological symptoms e.g. anxiety, depression

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14
Q

What is there a heavy focus on in psychodynamic therapy?

A

Heavy focus on therapeutic process rather than content -> may not be as much structure as in behavioural appraoches

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15
Q

Behavioural model (learning theory)

A
  • Assumes behaviour is learned -> therefore behaviour can be unlearnt
  • Three main ways of producing behaviour
  • > Classical conditioning
  • > Operant conditioning
  • > Social learning
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16
Q

Classical conditioning

A
  • Associative learning

- Unconditioned stimulus (food) paired with neutral stimulus (bell) to produce conditioned response

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17
Q

How do you learn in operant conditioning

A

Learn based on contingencies of behaviour

Positively reinforced - likely to repeat that behaviour

18
Q

Social learning

A

Learn from ppl around us/what we see around us

19
Q

Behavioural approaches compared to psychology

A

Much more content focused

20
Q

Sex/Gender causing MH problems

A
  • Almost all mental health problems are more
    common in females, e.g., Depressive Disorders,
    Anxiety Disorders, Eating Disorders
  • Exceptions:
  • Adults
    -> Substance Related Disorders
    -> Antisocial Personality Disorder
  • Children
    -> Attention Deficit Hyperactivity Disorder (ADHD)
    -> Conduct Disorder
21
Q

Why are women more likely to experience major depressive episodes over their lifetime as well as in their past compared to males?

A

Generally comes down to females expressing more depressive things
But other factors may include:
-> Dealing in different way - males - substance-use/self-medicate
-> Hormonal differences
-> Social pressures
-> More acceptable for females to express emotion -> they’re more likely to seek help
-> Men don’t have vocab to express difficulties

22
Q

Genetics causing MH problems

A
  • Mental illness runs in families
  • E.g., Obsessive Compulsive Disorder (OCD):
    first-degree relatives of individuals with OCD
    have a risk for OCD two times greater than
    general population (10x greater for childhood
    onset).
  • Concordance rate higher in monozygotic vs.
    dizygotic twins -> higher heritability of MH problems in monozygotic twins
23
Q

Problem when trying to figure out whether genetics is part of MH problem cause

A

When it comes to MH problems in families -> can’t tease apart if genetics or enviro because they live in same/similar enviro

24
Q

Why are MH rates in twins not perfect?

A

If MH problems were purely based on genetics would see perfect concordance rates in monozygotic twins which is not seen
-> Genes play some role but not the only role in MH problems -> genetics may make ppl vulnerable - pre-genetic position to developing certain conditions - but may not manifest if something else present (enviro)

25
Traumatic brain injury
- Research suggests causal link between traumatic brain injury and depression and anxiety disorders - > Traumatic brain injury acted as a stressor -> increased vulnerability for depression/anxiety disorders
26
Brain abnormalities
Read et al. (2004) highlighted similarities found in brains of severely abused children and adults diagnosed with Schizophrenia -> Acquired brain injuries - tumours, hemorrhages, birth defects, surgery, abuse as child (can change physiological structure of brain), substance abuse
27
Poverty
``` - Relative poverty = difference between richest and poorest - Strong predictor of the rates of mental health problems in different countries – even when comparing relatively wealthy countries ```
28
The prevalence of mental illness is higher in more unequal rich countries
As income inequality increases so does %age with MH problems
29
Ethnicity
Relationship between high rates of mental health problems and being a member of an ethnic minority or of a colonised indigenous people: E.g., in the UK, African-Caribbeans are 9 to 12 times more likely to be diagnosed with Schizophrenia than white people (Read, 2004)
30
Ethnicity Discrimination
Less likely with own people but increase in MH problems not due to being from ethnic minorities but because of what they experience
31
NZ Research: Te Rau Hinengaro: The New Zealand Mental Health Survey (2006)
- 20.7% of NZ population met criteria for a disorder in the past 12 months - 29.5% for Māori, 24.4% for Pacific people, 19.3% for Others
32
NZ Research: Psychiatric inpatient admissions in Auckland (Wheeler et al., 2005)
60% European, 23% Māori, 11% Pacific people, 4% Asian -> Also to do with less common MHPs -> overrepresentation of Maori
33
Ethnicity
- Relationship between high rates of mental health problems and being a member of an ethnic minority or of a colonised indigenous people explained by: -> Poverty -> Level of discrimination experienced -> Isolation from ethnic group/loss of cultural identity
34
Trauma takes many forms
``` Child abuse (physical, emotional, sexual) Child neglect Bullying Rape and physical assault War trauma ```
35
Prevalence of Abuse in Psychiatric Inpatients
``` Average child abuse rates from review of inpatient studies - Female inpatients: O Sexual abuse: 50% (Incest: 29%) O Physical abuse: 48% O Either sexual or physical: 69% - Male inpatients: O Sexual abuse: 28% O Physical abuse: 51% O Either sexual or physical: 60% ```
36
Loss
- Loss is an inevitable part of life – and comes in many forms Factors predicting an extreme response to loss: O Previous losses O Lack of support/understanding O Importance of lost person or thing
37
The Adverse Childhood Experiences (ACE) study
- 17,337 participants who sought health services from Kaiser Permanente - 10-item ACE survey - Abuse (emotional, physical, sexual) - Neglect (emotional and physical) - Household dysfunction (domestic violence, divorce, presence of substance-abusing, mentally ill, or incarcerated member of the household) - An individual’s ACE score reflects total number of adverse experiences endorsed by individual
38
What is ACE interested in?
Accumulation of different MHPs/adversities
39
What happens as ACE score increases?
Physical medical problems + also related to MH
40
Biopsychosocial approach
- Psychologists generally believe that mental health problems are caused by interactions between biological, psychological, and social/environmental factors - Vulnerability stress model/diathesis-stress model integrates different factors, assumes mental health problems result from a biological or psychological vulnerability together with stressful life event(s)
41
What is commonly used to explain the development of diathesis?
Mental Health Problems