mental health Flashcards
% aus w mh concern; % first nation w high/v high
22; 31
positionality
recognising on’es position to place and time, using it in contet of abilities, strengths,m weaknesses when it comes to helping/understanding people as a psych
decolonisation
not getting rid of but adding to + including other knowledge systems for a wider range of people
why did aps apologise 2016
failing to recognis + emplyoy first nations, didn’t pruduce diagnostic tools suitable to their understanding of mental social physical wllbeing
huyman rights and self-declaration
right to determine and develop, active involvement in health social economic ourcomes == employed in governing fields
cultural awareness
knowledge of culture, practice, how to exist well and live on certain country
cultural responsiveness
putting knowledge into practice and existing on country
cultural competency
interchangeable w cultrural responsiveness - put knowledge into practice
cultural safety
must come from person whose needs being met - are u responsible
reflexivity
critically examining values, attitudes + biases w view to engaging w people that is culturally safe (free from racism, attitudes of superiority)
3 ds
dysfunction, distress (oneself or others), deviation - all depend on person
pyschiatrist path, role
biomedical
MD, specialisation - internship, residency, vocational training, 5 yrs for FRANZCP (over 10yr)
+/- of biomedical model
+ meds can be rlly effective
- reductionistic, reduce psychological complexity, over-extrapolation from animal research
psychoanalysis treatment, significance, critiques
t: build insight into unconscious, conflicts + defence mechanisms
s: revolutionised concept of mental illness
c: unfalsifiable
humanism era, key players, causes of maladjustment, treatment, critiques
1960s-70s, reaction to psychoanalytic negativity
kp: maslow + pyramid, rogers
m: selfactualisation not right cos you can’t be who ur supposed to be
t: empathy + unconditional positive regard, who patient wants
c: no good for severe situations
behaviurism era, key players, maladjustment causes, treatment, critique
e: early-mid 20th cent, reaction to psychoanalysis unfalsifiable
kp: pavlov, skinner
maladjustment: classical + operant conditioning - how things/reactions in past alter how react/intepret today
t: breaking learned cycles - exposure therapy
c: overemphasis on behaviour, not cognition
cognitive-behavioural era, players, maladjustment, treatment, critiques
e: now
kp: aaron beck
m: grow up w core beliefs abuot self (worhtless, loved), cognitive distortions/biases
t: break thought patterns, influence feeling + act, psychoeducation
c: takes a while
evolution of DSM approaches
1 + 2 v influenced by psychoanalysis, so later = more determined to give diagnostic advice but then also shift into more fluidity
key diff between DSM 4 + 5 for anxiety
added selective mutism, removed acute stress, PTSD, OCD in own categories
panic attacks
period of intense fear/discomfort appearing abruptlyt, peak within 10 mins, autonomic arousal, can be added to any disorder
panic disorder
recurrent unexpected trigger, at least one followed by >1 month worry of having another, inc maladaptive change in behaviour related to attacks
not intuitive panic related behaviours
doing little or big things that make you feel safe eg wearing a cosy jacket, if you don’;t get a panic attack you misattribute and thinkg the action/object is the think protecting you and you still think the danger exists
clark cognitive model of panic disoreder
misinterpret bodily sensations, spirals
treatment for panic disorder
CBT, interoceptive exposure: exercises inducing physical sensations of panic attack, challenge beliefs about it
subtypes of specific phobias
animals, blood/injection/injury, natural environment, situational
prevalence/course of specific phobias
7-9% aus adults, more common in females, starts in children, sometimesd following traumatic event
prevalence/course of major anxiety disorder (MAD)
6% prevalence
31-39 yrs onset, more females, most don’t seek profesisonal help, unlikely to improve wo help, severity fluctuates over time
obsessions
repeated intrusive irrational thoughts causing severe anxiety/distress
compulsions
attempts made to ignore, suppress, neutralise the obsessions
common compulsions
washing/cleaning, checking, repeating, ordering/arranging, mental compulsions
4 dimensions of common obsessions
contamination
doubt/harm
symmetry/order
forbidden/taboo
ocd meds
barbituates, benzos, ssris
barbituatesq
quick, risk OD, interacts w alcohol, high relapse
benzos
quick, addictive, interacts w alcohol, high relapse
antidepressants/ssris
slower acting, fewer side effects, common relapse
DSM 4 –> 5 mood disorder change
4 = whole bunch o diferent; 5 = diff categories, add disruptive mood dysregulation disorder, premenstrual dysphoric disorder,
REQUIRED SYMPTOMS of depressive disorder
depressed mood most of the day nearly every day, markedly diminished pleasure/interest in activities
prevalence + course of mdd
5-25% depends on age, gender, 3rd highest burden of all diseases in aus, onset after puberty usually peak in 20s, variable course
PDD
longer (>2yrs) and not necessarily milder; appearabce of higher functioning. not more than 3 months wo symptoms; for MDD it’s waves
heritability of depression + biological causation theories`
35-60%, neurochemistry (noradrenaline/serotonin bad cos SSRIs work), absorbing excess cortisol, vulnerability stress model = biological vulnerability + stress = depression
DSM 4 - DSM 5 eating disorders
BINGE EATING DISORDER IS NEW TO DSM 5
4: 3 categories inc EDNOS covering bing, purge etc. 5 reclasified, added pica, rumination disorder
anorexia nervosa severity
most fatal, 5-10% over 10 yrs, highest mortality of all psychiatric disorders
anorexia nervosa prevalence
least prevalent, 0.5%-1% of all females, 90% ppl w AN are female, getting younger and younger starting, chronic, slow recovery, 50% go on to develop bulimia nervosa
bulimia prevalence + course
1-3% of females, 90% w BN are female, adolescence/early adulhood, long term outcome better but 10% still affected after 10 yrs
binge eating prevalence + course
2.5% population, 2:1 female:male, remission rates higher, assoc w obesity, high blood pressure, cholestrol, etc
ED biological causation
genetic: moderate heritability, neurotransmitter disturbances - serotonin involved inappetite regulation
ED psychological causation
transdiagnostic: using fact it involves self worth in weight/shape, proposing core low self esteem, perfectionism, distress tolerance
ED sociocultural causation
family factors - high parental criticism, control, conflict
peers - peer group w ED, social approval
sociocultural - media, body dissatisfaction is single highest predictor of ED, prevalence in occupations where strong thin-ideal –> modelling, ballet
Maudsley family based therapy steps
- parents in charge of weight restration + refeeding
- parents transition control over eating back to adolescent
- discuss developmental issues, establishing healthy identity
