Mental Health Flashcards
Mental Health Module Aims & Learning Objectives
Aims:
* Mental health and mental health disorders
(continued from Level 1)
- Mental health and wellbeing
- High and low prevalence mental illness
- Social and emotional wellbeing (SEWB) for
Aboriginal and Torres Strait Islander peoples, and - Treatment approaches for psychological disorders
and mental health
Learning Objectives:
* Demonstrate an understanding of mental health and
wellbeing
* Describe high and low prevalence mental health
disorders
* Discuss SEWB in Aboriginal and Torres Strait Islander
peoples
* Demonstrate a basic understanding of treatment
approaches for mental health, including approaches to
supporting positive mental health
Classifying Mental Ill-health
DSM-5 & ICD-11
DSM-5
* American Psychiatric Association
* Mental health conditions only
* Widely used in Australia in clinical
settings
* Published 2013, text revision 2022
ICD-11
* World Health Organisation
* Includes both physical and mental
health conditions
* More often used in research settings
* Published July 2018
Changes over DSMs II-IV
- Shifting from theory based to symptom focused, using lists of observable signs to define
criteria - Increased emphasis on research evidence for disorders
- Increased number of disorders defined, inclusion of disorders relevant to outpatient mental
health (e.g., anxiety disorders, depression, disorders of childhood) - Changes in labelling of disorders (e.g., ‘mental retardation’ to ‘intellectual disability’)
The Diagnostic and Statistical Manual of
Mental Disorders (DSM)
- First published in 1952 (DSM-I)
- 132 pages, 128 diagnoses
- Inpatient psychiatry focused - disorders with and without organic basis, psychoneurotic
disorders, personality disorders, “mental retardation” - No inclusion of conditions of childhood and adolescence
- Predominantly based on theoretical constructs
Potential benefits of diagnostic classification systems
- Standardisation: standardizing the language of diagnosis helps clinicians communicate effectively and
promotes consistency in research and treatment. - Accessibility: The manual is widely used (albeit at a cost), making it easier for professionals across the world
to communicate and collaborate on diagnosis and treatment. - Research and Treatment: The DSM has facilitated research by providing a common framework for studying
and understanding mental health disorders. It has also assisted in guiding treatment decisions. - A person experiencing difficulty can benefit from having a name and framework for understanding these
difficulties/differences
DSM-5 Broad changes
- Revised text for almost all disorders in accordance with
updated research evidence (e.g., prevalence, risk factors) - Improvements in ‘harmonisation’ with ICD-11
- Comprehensive review and update of terminology to more
inclusive terms (e.g., race -> racialized, removal of ’minority’) - Consideration of impact of racism and discrimination on
disorders integrated throughout - Updated details on cultural considerations related to
illness and distress - Male/female checkbox options removed in assessment
tools - recognition that gender is not a binary construct
Mental Illness: Define
The World Health Organisation (WHO) defines mental health as:
“a state of well-being in which every individual realizes his or her own potential,
can cope with the normal stresses of life, can work productively and fruitfully,
and is able to make a contribution to her or his community.”
Mental disorders (or mental illness) are defined by the American
Psychiatric Association as:
“A syndrome characterized by clinically significant disturbance in an individual’s
cognition, emotion regulation, or behavior that reflects a dysfunction in the
psychological, biological, or developmental processes underlying mental
functioning. Mental disorders are usually associated with significant distress or
disability in social, occupational, or other important activities.” (APA, 2013)
DSM-5
- Published in 2013
- 947 pages, covering 541 diagnostic categories
- Shift toward ‘dimensional’ approach and use
of ‘spectra’ rather than discrete categories - For each disorder:
- Diagnostic features and criteria
- Prevalence rates
- Development and course (etiology)
- Risk and prognostic factors
- Differential diagnosis
Disorders (example)
Neurodevelopmental Disorders
Schizophrenia Spectrum and Other Psychotic Disorders
Bipolar and Related Disorders
Depressive Disorders
Anxiety Disorders
Obsessive-Compulsive and Related Disorders
Trauma- and Stressor-Related Disorders
Dissociative Disorders
Somatic Symptom and Related Disorders
Feeding and Eating Disorders
Elimination Disorders
Sleep-Wake Disorders
Sexual Dysfunctions
Gender Dysphoria
Disruptive, Impulse-Control, and Conduct Disorders
Substance-Related and Addictive Disorders
Neurocognitive Disorders
Personality Disorders
Paraphilic Disorders
Other Mental Disorders and Additional Codes
Some criticisms of the DSM-5
- Large number of disorders - over pathologizing?
- Categorical classification
- Comorbidity
- Reliability
- It is WEIRD!
Western, Educated, Industrialized, Rich, and Democratic.
How do psychologists understand mental ill health?
How do psychologists understand mental ill health?
An hypothesis about causes, precipitants, and
maintaining influences of a person’s
psychological, interpersonal and behavioural
problems
Aboriginal
and/or Torres
Strait Islander
perspectives on
mental health
Social and Emotional
Wellbeing (SEWB)
Historical Determinants - Political Determinants - Social Determinants
infuence self
- connection to the body
- connection to the mind and emotions.
- connection to family and kinship
- connection to community
- connection to culture
- connection to country
- connection to spirit and spirituality and ancestors
Case formulation - “4 P’s”
Predisposing - factors that make a person more vulnerable to experiencing a problem
Precipitating - factors that have triggered a person to experience a difficulty at
this time
Perpetuating - factors that maintain the problem
Protective - factors that help alleviate the problem or difficulty
Benefits of case formulation
- Organises information about a person and difficulties they are experiencing
- Guides intervention
- Helps to measure change
- Helps psychologist/clinician understand the client and supports development of a positive
client-therapist relationship
What are the
determinants of
mental ill health?
- macro level context
- wider society
- systems
- life-course stages
accumulation of positive and negative effects on health and well-being over the life-course
prenatal - early years - working age - older ages
^family-building^
prepetuatuon of inequities
Social determinants of Mental Disorders and the Sustainable Development Goals: A Systematic Review of Reviews
Refer to diagram - slide 20 Lecture 1: Mental Health
summary
- Mental health vs mental illness
- Diagnosing mental health conditions
- Case formulation
- Determinants of mental health
Wellbeing
Optimal functioning in many domains of life (mental, emotional, social,
physical, etc.)
* Historical perspectives: hedonia & eudaimonia
* Subjective wellbeing Diener (1984)
* Psychological wellbeing Ryff (1989)
* Authentic happiness (2002) to PERMA Seligman (2011)
* PERMA = Building blocks of wellbeing
Bronfenbrenner’s Ecological Systems Model
Refer to diagram - slide 21 Lecture 1: Mental Health
Lecture 2: Overview
Part 1: Positive aspects of mental health
* Mental health model
* Positive Psychology
* Wellbeing
* Research
* Factors that contribute to wellbeing
Part 2: High and low prevalence MH disorders
* Anxiety and depression
* Obsessive compulsive disorder
* Eating disorders
Dual model of mental health
“…mental health and mental illness are
not opposite ends of a single
continuum; rather, they constitute
distinct but correlated axes that suggest
that mental health should be viewed as
a complete state. Thus, the absence of
mental illness does not equal the
presence of mental health.” (Keyes,
2005, p. 546).
refer to diagram page7: Lecture 2 and 3
Positive Psychology
- Moving away from a perspective that only considers alleviating suffering, to focus
on “what makes life worth living” - “A science of positive subjective experience, positive individual traits, and
positive institutions…”
History - Psychoanalysis > Behaviour > Humanistic > Cognitive > Third wave > Positive
- Martin Seligman
- Learned Helplessness
- President of APA
- Positive psychology: an introduction
- Today…
Research
Scoping Review (including 190 studies)
* PERMA components were positively correlated
with or described as important for resilience,
wellbeing and positive mental health. All
components were found to negatively correlate
to mental disorders or symptoms.
* Relationships were the most represented of
PERMA in the literature, and parent-child
relationships were found to be particularly
important for the outcomes.
Intervention research
- A meta-analysis of positive psychology interventions has shown an
increase in wellbeing and a decrease in depressive symptoms with
low to medium effect sizes (Bolier et al., 2013) - Interventions:
- Gratitude
- Optimism
- Kindness
- Savouring
- Hope
Factors that contribute to wellbeing
PERMA
Positive Emotion
Enagement
Relationships
Meaning
Achievement
Factors that contribute to wellbeing
- Character strengths
What is “…right about people and specifically about the
strengths of character that make the good life possible”
(p. 4) - Hope
- Gratitude
- Kindness
(Peterson & Seligman, 2004)
To see all 24 character strengths (or take a free test
to find out your greatest strengths):
https://www.viacharacter.org/
Factors that contribute to wellbeing
- Research also supports
- Mindfulness (e.g., Amundsen et al., 2020)
- Physical health – exercise, sleep & diet (e.g., Mikkelsen et al., 2017),
- Self-compassion (https://self-compassion.org/)
- The Five Ways to Wellbeing initiative - Connect, Be Active, Keep Learning, Be
Aware and Help Others (https://www.5waystowellbeing.org.au/) - Mindfulness activity:
https://www.youtube.com/watch?v=IQYjWv59VYU
Three Good Things
- List 3 things you’re grateful for
- Research suggests:
- This task improves positive affect, prosocial motivation, sleep and results in
fewer health complaints - This task appears to be more effective when completed daily as opposed to
weekly
(Emmons & McCullough, 2003)
Lecture 3: Mental Health Disorders
Anxiety disorders in the DSM-5
▪ Separation Anxiety Disorder 309.21 (F93.0)
▪ Selective Mutism 312.23 (F94.0)
▪ Specific Phobia (300.29)
▪ Social Anxiety Disorder 300.23 (F40.10)
▪ Panic Disorder 300.01 (F41.0)
▪ Agoraphobia 300.22 (F40.00)
▪ Generalised Anxiety Disorder 300.02(F41.1)
▪ Other specified Anxiety Disorder 300.09 (F41.8)
▪ Unspecified Anxiety Disorder 300.00 ( F41.9)
