Lecture 8 Mental health Flashcards
What is mental health? What is psychopathology?
- Psychopathology:
1. Positive self attitudes (self estime)
2. Accurate perception of reality (no hallucinations)
3. Mastery of environment (ability to function with day to day tasks)
4. Autonomy
5. Personality balance (no wild mood swings, shifts in personality)
6. Growth and self actualization
What is the problem with this view of mental health?
- They are largely western based, not always inclusive of other cultures
Hechanova & Wealdle (2017)
Five main cultural components that need to be taken into account:
1. Emotional expression: some cultures believe that talking about pain creates more pain.
2. Shame: some cultures believe talking about problems brings shame to the family or individual
3. Power & relationship: is one culture dominating the other? Be mindful of balances.
4. Collectivism: how does the person view group vs individual
5. Spirituality and religion: can affect what is viewed as a symptom and coping strategies
ex. hallucinations
Mental health factors
- Physical/Biological:
- neurological factors
- genetic factors (ex. Alzheimer’s and dementia
- Mental health components could be due to vitamin deficiencies (environmental effect) - Psychological
-age related changes to memory, personality and cognition can underline different behavioural changes - Sociocultural
- must ask if behaviour is normal for culture before asking if it’s mental health related
Multidimensional Assessment
*Focusing on multiple aspects of someone’s life rather than just diagnosing from the DSM
*Done by a team of different professionals (psychiatrist, therapist, nurse/doctor, social workers…) this helps create a more holistic view of someone’s wellness
*Screening (used to see if someone qualifies for further support) vs. diagnosis
ex. bcap- tells you if a parent is at risk for abusing a child.
- doesn’t say if parent is abusing child already
- helps you catch abuse early on
*Ideally it would be a combination of performance tests and daily life functioning
What drives bias in assessment?
- Stereotypes!
- Positive vs. negative bias
Positive bias occurs when individuals or systems favour positive attributes or outcomes, often leading to overly optimistic interpretations.
ex.
Negative bias occurs when individuals or systems focus on negative aspects, often overestimating risks or problems
ex. someone holds an identity based stereotype and might diagnose something that a person doesn’t actually have
Physical health issues
- if people are experiencing physical and mental health issues, people tend to overlook the mental
It’s important to use many methods to assess. Why?
Different methods can:
- give more information
- fill in information
- can learn in different context
ex. family report and observation on daily life tasks of older individual
Different methods
- interviews self reports surveys, neurological testing observations performance tasks…
Depression (gasp)
The belief that “all older adults are depressed” is an ageist stereotype.
ex. positivity effect socioemotional positivity theory
*Risk factors: people with chronic health conditions or pain or nursing home residents
*Higher for women, variable by race/ethnicity
Why? (according to Jess)
- Role of gender socialization
- Role of internalization (girls are socialized to internalize problems and to express emotion through sadness)
✨ Anxiety✨
What are the types of disorders?
Latter life symptomes?
Types of disorders
1. generalized anxiety disorder (not specific, just sorta hangs around)
2. Panic disorders
3. Phobias
4. Social anxiety disorder
5. Separation anxiety disorder (not just with little kids)
*Again, women more likely than men
*In some cases, anxiety is reasonable, so may be difficult to work through
ex. someone is afraid of scorpions, and they have a phobia of them and see them often
- When an anxiety is getting in the way of daily life, then that’s an issue
*Most common later-life symptoms
- stress impairment frequent uncontrolled worry muscle tension and sleep issues
*Treatments: therapy is preferred to medication
Alcohol abuse
Alcohol abuse rates much higher for men
*Longer term heavy drinking = worse outcomes
*Drinking norms differ by country (age drinking is legalized)
*Triggers for developing a drinking problem in later life
- Retirement loosing a spouse chronic pain having to leave their house.
*May lead to issues with medications (they can interact poorly)
*Older adults more at risk for alcohol abuse due to normative biological changes (takes less alcohol to feel effects and stays in blood longer)
- their tolerance gets lower
Delirium
-Rapid-onset confusion and reduced awareness of environment
Cognitive changes:attention difficulties memory troubles difficulty orienting rambling/incoherent speech…
Causes: medication side effects, stroke, dehydration sleep deprivation
About 1/3 of cases are preventable, almost all cases are reversible and treatable once the cause is found, though in some cases there can be permanent brain damage or even fatality
Alzheimers disease
Most common form of progressive, degenerative, and fataldementia, accounting for 60-80% of dementia cases
*More prevalent in women and older adults (risk goes up the older you get, and women live longer than men)
*Symptoms: memory lose, difficulty with daily life problem and familiar tasks, confusion with time or place, misplacing things, poor judgment, imaging processing,social withdrawal changes in mood and personality
- Sypmtomes worse in eavnening
*In advanced stages, causes incontinence and immobility
*Assessment is extensive: you want to rule out other disorders first because alzheimers is none treatable- last resort
Neurological Causes of Alzheimer’s
- Rapid cell death: dramatic brain shrinkage in hypocampus (responsible for memory), cortex and basl forebrain
- Neurofibrillary tangles;neurons made up of diff nero fibers.
- Get tangled up because there’s too much phosphate binding with the proteins
- it tangles the neurofibers
this makes it hard for nutrients and information to travel through the neuron
- Eventually it can die - Neuritic plaques
- Proteins called beta amyloid proteins that clump up with neuron detritus (neuron junk)
- clump up on and around neurons.
- similar to heart attack where plaque builds up in arteries
- neurons get clogged up and information can’t pass through
Neuro changes are similar to
normative aging, but more rapid and
more dramatic
Genetic Causes of Alzheimer’s
Early onset (before 65) often related to gene mutations responsible for beta-amyloid protein production
*Later onset (after 65) often related to 9 different genes which are responsible for different processes
*One chromosomal trait related to neuritic plaques
*Beta-amyloid deposits could be linked to infection and inflammation- brains not as efficient at flushing out waste
Alzheimer’s Treatment
Currently there is no cure, no prevention, no treatment, only care and alleviation of symptoms
Mostly behavioural interventions
ex calendars or spaced retrieval (gradually taught to remember things with spaced intervals)
Most effective when paired with broad social support & service provider support
