mental health Flashcards
1
Q
What’s important when we talk about mental health?
A
- Boundaries
- Nonjudgmental
- Compassion
- Respect
- Empathy
- Proper understanding to break down stigma
2
Q
Psychiatric movement
A
- Use criteria from DSM5 to match against individuals’ symptoms
- This matching process is used to decide whether the individual meets the diagnosis for a mental disorder
- DSM is a older more strict idea of mental illness that is being pushed aside for a newer looser and more rounded idea of mental illness
3
Q
Anti Psychiatric movement
A
- Pioneers were Laing, R.D. (1967) and Szasz, T (1974)
- More recent thinkers like Dr Bentall wonder why psychiatric treatments fail (2009)
- Are mental health issue pathological (old view) or are they physiological responses to stress (new)?
- Argument for mental health issue being an appropriate response to stress (physiological)
- Adapt to stressors as a response to conditions of risk ????????
4
Q
Rosenhan Experiment or Thud Experiment
A
- Rosenhan Experiment or Thud Experiment (1973) was conducted to determine the validity if psychiatric diagnosis
- Healthy associates or “pseudopatients” (3 women, 5 men, including Rosenhan himself) who feigned auditory hallucinations in an attempt to gain admission to 12 psychiatric hospitals in 5 states in the US. All of them were admitted and diagnosed with psychiatric disorders
- “it is clear that we cannot distinguish the sane from the insane in psychiatric hospitals” – cant tell who is healthy or unhealthy
- Illustrates the dangers of dehumanization and labelling in psychiatric institutions
- Shows: we can’t tell who is sane/insane, there are dangers of dehumanization and labeling
5
Q
evolution of types of thoughts in psychology
A
- Behavioral
- Focused on conscious behavior
- Considers events, thoughts, and emotions in the present - Psychoanalytic
- Uncover unconscious motivations
- Focused on treating mental illness
- Go back into past to understand why we overreact due to past events - Humanistic
- To empower one to reach full potential
- Focused on self actualization
- What are you missing? Fill in blanks
- Not mental illness - Transpersonal
- Goes beyond the person and includes transcendent and spiritual experiences
- Goes beyond self into unseen needs
6
Q
General emotions
A
- Universal human attributes
- Adaptive value in signaling and responding to events
- Emotions are healthy phenomenon
- Affect behavior, neurochemistry, perception, communication, social bonding
- emotional Imbalances = disease
- Adaptive (functional) vs maladaptive (dysfunctional): evolutionary adaptations that become dysfunctional and affect well being
7
Q
Emotion: Love
A
- Adaptive because it could be a reinforcement mechanism for pair bonding which helps the health and survival of offspring
- Jealousy = mechanism to prevent pair splitting
- Excessive jealousy = possessive and maladaptive
- Positive feeling like happiness and love promote goodbehaviors
- Maladaptive attachment = when emotions are too strong it can be bad
- Community/group health is improved by love
8
Q
love and infant bonding
-attachment theory
A
- Adaptive for strong attachment to mother
o Infant bonding is key for healthy development
o More love = better care = better survival and health of kid
o Promotes reproductive success
o Oxytocin
Attachment theory: healthy development depends on at least 1 strong emotional or physical attachment - All kids need it especially before age 1
9
Q
Attachment vs parent-offspring conflict
A
- Infants wake up frequently
- Disrupt caregivers sleep: parent-offspring conflict
- Attachment theory
o Prompt parental responses leads to suckling which leads to lactational amenorrhea
o Evolutionary ideas on POC: it is an advantage for the child to delay the arrival of a sibling
o No longer fits the modern developed world since other factors may have a greater impact on lactational amenorrhea - Baby wakes up in middle of night = mother gets up and feeds it = lactational amenorrhea = no period = no pregnancy = no siblings to compete with
10
Q
Stress Hormones
A
- Adrenaline and noradrenaline
o Fast acting
o Regulate direct functions
o Fight or flight - rest and digest - Cortisol
o Allows fast acting hormones to work better because it regulates gene expression
o Long acting
11
Q
cortisol
A
- Glucocorticoid hormone produced by adrenal glans with major effect of increasing circulating free fatty acids and glucose
- Increases protein catabolism
- Decease inflammation
- Increase glycogenolysis = increase release of glucose by breaking down glycogen
- Increase gluconeogenesis = synthesis of glucose from alternative sources
- Increase lipases
12
Q
Positive effects of fear/stress
A
- Improves brain performance
- Motivates action
- Promotes companionship
- Different responses depending on the task from person to person
13
Q
types of stress
A
Acute stress: is stress from a new or unpredictable event that is highly treatable and manageable
- When the acute response is exaggerated or reduced, pathological consequences may develop
Episodic acute stress: frequent inability to cope
Eustress (adaptive): helps with effort and performance but not harmful
Distress (maladaptive): hinders performance and causes harm
14
Q
episodic acute stress
A
- frequent inability to cope
- avoidance, withdrawal, escape from stressor
- greater sensory awareness and alertness
- overstimulation of the stress response
- type A personality (seep seated insecurity leading to overachiever profile) – perfectionism
- long periods of acute distress could lead to OCD, anxiety disorder or hypochondriac
15
Q
Negative effects of fear/stress
A
- inappropriate responses
- chronic stress = repeated exposure
o neural changes impair memory and changes mood
o linked to suicide, CVD, obesity - abuse and neglect in early life correlate with overactive HPA stress response
o evolutionary adaptation to be ready to respond to emergency – adaptive but easily becomes maladaptive
o trained to deal with stress so physiological response to something that happened before helps them know what to do better the next time
15
Q
anxiety disorders (broad)
A
- disorder = anxiety never goes away
- are energetically costly
- many types: generalized anxiety disorder, panic disorder, social anxiety, phobia related disorders, PTSD
16
Q
generalized anxiety disorders (GAD)
A
- involves a constant and intense feeling of anxiety regarding anything
- people with GAD struggle to control their worries
- they tend to anticipate some sort of disaster, despite a lack of evidence
- debilitating
- GAD7 is 7 question test for GAD
17
Q
panic disorder
A
- experiencing panic attacks that appear out of nowhere and occur unexpectedly
- the attacks are so intense they create anxiety about experiencing them in the future
- symptoms: feeling dizzy, unsteady, lightheaded, faint, sweating, fear of dying
18
Q
social anxiety
A
- people have intense fear of others judging them in social or performance situations
- they are terrified of potential embarrassment or humiliation
- anxiety can be extreme to point of inhibiting the ability to socialize, date , travel
19
Q
PTSD
A
- major traumatic even like an accident, trauma, violence
- trauma is always subjective it is how one responds to an event
- night mares and flashbacks
- mood and emotions
- initially adaptive but can become maladaptive
- adaptive evolutionary reason: when something scary happens you adapt to fear it happening again
20
Q
phobia related disorders
A
- exaggerated fear
- classified based on cultural norms (learned verbally or nonverbally)
- hypersensitive smoke detector (HPA axis)
- preparedness theory: avoiding dangerous situations may provide one with a selective advantage
21
Q
Biological preparedness theory for anxiety
A
- anxiety disorders evolved based upon defensive evolutionary survival functions- readiness to deal with dangerous environmental stimuli
- adaptive: most common phobic stimuli (snakes, spider, the dark, blood, height, open spaces) needed to be avoided to avoid death or injury
- maladaptive in present day: these reactions of dread, avoidance, and hyper alertness still trigger the fight/flight response, to a human’s detriment. Stress response can lead to anxiety disorders and ability to function
- support for this: studies on animals have illustrated that phobias of dangerous stimuli are learned more readily than phobias of non-dangerous objects
22
Q
Preparedness theory for anxiety
A
- evolutionary reason to fear: small animals, dangerous animals, closed spaces or heights, thunderstorms, running water
- fears of modern dangers like cars or guns
- preparedness theory doesn’t apply to modern dangers because they are so recent and the old ones have evolved over millions of years
Critiques of preparedness theory: - not scared of poisonous plants or fungi
- dangers vary
- why are we so scared of spiders
- rearing environment is involved since the environment you are exposed to shapes what you fear
- many types of dangerous things but only certain things have phobias majorly associated with it
23
Q
5 therapeutic models
A
- cognitive behavioral therapy
- psychodynamic therapy
- humanistic therapy
- mindfulness
- medications
24
cognitive behavioral therapy model
- negative patterns of thoughts about self and world are challenged in order to alter unwanted behavior patterns or treat mood disorders like depression
- focused on symptoms rater than root cause of distress
- goal oriented
25
psychodynamic therapy model
- developed from psychoanalysis
- long term approach to mental health treatment
- focused on understanding and expressing the underlying causes of distress
- figure our why you feel that way and how its rooted in past events
26
humanistic therapy model
- person is a whole , they don’t need fixing
- developed from humanistic theories
- holistic approach focused on free will, human potential and self-discovery
- aimed at developing a strong sense of self
- patient centered
27
mindfulness model
- is a form of metacognition: patient is aware on their thoughts and feelings to be present in the moment, without interpretation or judgment
- practicing mindfulness involves breathing methods, guided imagery, and other practices to relax the body and mind and help reduce stress
28
medication model
- selective serotonin reuptake inhibitors (SSRIs): work by increasing levels of serotonin within brain
29
Personality and personality disorders in general
- five factor model of personality by Costa, McCrae, John in 1990
- 5 key traits(OCEAN): Openness, conscientiousness, extroversion, agreeableness, neuroticism
- personality disorders involve **maladaptive and inflexible** expression of basic dimensions of personality
- any personality trait can be adaptive or maladaptive
- maladaptive when have extremes of emotions/personalities
30
A personality disorder is NOT
- someone who isn’t very “nice” or has a “bad personality”
- a person who displays **overt behavior** – anger, eccentricity, out of control
- someone who doesn’t like themselves or has things about their personality they want to change
31
A personality Disorder IS
- causes distress
- has a genetic predisposition
- 4 Ds: deviance, dysfunction, distress, danger
- Usually is trauma based – traumatic history
32
There are 10 categories of personality disorders in DSM5 but most prevalent are:
- Anti social PD: violation of rights of others, break laws/rules, murderers
- Borderline PD: unstable relationships, impulsive behavior, hard to distinguish what is real or not
- Avoidant PD: social inhibition, inadequacy
- Dependent PD: submissive and clinging behavior, need to be taken care of
- Obsessive compulsive PD: preoccupation with orderliness and control
- Narcissistic PD: grandiosity, need for admiration and attention
33
Dimensional model of PD
- New approach: eliminates discrete disorders and replaces them with a range of personality traits or symptoms (on a spectrum)
- Old approach: check boxes and follow guidelines
- All people are on the spectrum but where we rage on it is different and it becomes an issue when it leads to disruption of life and distress
34
Biosocial theory of personality disorders
- Genetics + trauma= personality disorder
- Bisocial theory: biologically determined personality traits reacting to environmental stimuli
- A genetic predisposition coupled with an invalidating childhood environment – Marsha Linehan 1993
35
Co-morbidity
- Patients have symptoms of more than 1 psychiatric disorder
- Especially true of personality disorders
- Borderline patients often have co-morbid eating disorders and substance abuse
- Trauma is often an underlying factor
- Learned behavior is also another underlying factor especially learned in childhood from parents like if they are drug addicts
- Changing understanding of mental health issues
- Therapies are looking at treating the trauma, as opposed to individualized symptoms
36
Evolutionary explanations of deliberate self-harming behavior
1. Signaling theory: Deliberate self-harm is a signal to social partners of help
- Adaptive function: a credible communication of emotional pain (im really desperate) = I need help
- Secondary gains of attention and other desired reactions form social partners
- Maladaptive: is costly signaling because it threaten person’s fitness to survive
2. Bargaining theory: the signal puts the self-harmer in a bargaining position with social partners
- Adaptive function: convince skeptical social partners that the need is genuine, not a deceptive ploy to exploit them
- Secondary gains include attention and concern, a sense of control over others, mobilizing other to react
- Maladaptive function in modern day: self harming is costly to fitness and survival and can lead to entrenched pathologies where the individual ‘craves’ the harm as a release of emotional pain. There are now other ways we can achieve this like advanced language, therapy etc.
37
evoltion of modern communication
- 1859 Antonio Meucci invented first phone
- 1876 graham Bell patented phones
- 1971 first email sent by Ray Tomlinson
- 1973 martin cooper first mobile phone call
- 2003 skype founded – video telephony
- 2004 Facebook created by Mark Zuckerberg
- 2005 YouTube launched
- 2016 TikTok launched by Zhang Yiming
38
Info and Communication technology
- None of the following existed during our evolutionary history…
- Phone
- Cell phone
- Text
- Email
- Zoom
- WhatsApp
- Facebook
- Instagram
- TikTok
39
online content causes 6 main things:
1. Social comparison
2. Feelings of missing out
3. Feelings of inadequacy
4. Feelings of dissatisfaction
5. Physical isolation and loneliness
6. Cyberbullying
- All of these increase depression and anxiety rates
40
social media addiction
- Up to 5/10% of Americans meet criteria for social media addiction and is more prevalent in younger generations
- Behavioral addiction – operates on reward system – dopamine release
- Characterized by being overly concerned about social media, driven by an uncontrollable urge to log in to or use social media, and devoting so much time and effort to social media that it impairs other important life areas
- Experience typical symptoms of addiction
1. Mood modification – feel better after using it
2. Withdrawal symptoms – unpleasant symptoms without it
3. Tolerance – increasing over time
4. Conflict – personal problems due to use
5. Relapse – inability to disconnect
41
Screen time and physical activity
- More screen time = less physical activity
- Sedentary living increases morbidity and mortality (obesity, CVD, cancer, diabetes, etc.)
- Sedentary living contributes to depression and anxiety partially due to exercise releasing dopamine
42
Screen exposure at night
- Since the invention of TV in early 20th century the avg nights sleep has gone down by 2 hours
- Screens emit blue light that confuses the sleep centers (circadian rhythm)
o Melanopsin receptors in the eye detect blue light
o Light inhibits the (nocturnal) release of soporific hormone melatonin
o Melatonin regulates the circadian rhythm at night when there is no light
o Through melatonin, light reduces sleepiness, increased alertness and cognitive performance and interfere with sleep
- Sleep deprivation
- These factors contribute to CVD, obesity, cancers, etc.
- Poor sleep patterns contribute to depression and anxiety
- From evolutionary perspective its helpful to be awake when there is blue light which means daytime because color of sky
43
Effects of circadian rhythm
- Studies show that watching more TV at night messes with the circadian rhythm which increases the risk for diseases like CVD, obesity, etc.
- Circadian rhythm effects hormone production and bodily functions
- During day less melatonin and more cortisol and vice versa for night
- Dawn phenomenon: every morning has a significant increase in hormone activity which leads to more heart attacks in the morning
44
Advantages of living in era of communication
- Easier to access mental health services
o Lower cost
o 24-hour service
o Convenience
o More accessible
- Easier to access mental health apps
o Meditation apps
o Mindfulness apps
o Mood apps
- Easier to connect with dear ones
- Easier to reach out for support
- Easier to disseminated information
