Mental Health Flashcards
What does suicidality refer to
From thoughts to behaviours, can be current (now) or lifetime (any point in your life)
What is required for a mental health diagnosis
Need to be causing distress
Meet criteria in DSM-V
Clinical judgement
Co-occuerance with what condition could effect the likely hood of factors leading to mental health
asd
What is the challenge
Effectively identifying mental health problems
What are the four key areas of mental health
Environment
Biological
Societal
Psychological
What does environmental factors of mental health refer to
Stress, bereavement, finances, bullying, unemployment
What does societal factors of mental health refer to
Attitudes
Stigma
Policy
Poverty
What does psychological factors of mental health refer to
Thinking style
Coping strategies
Resiliance
What does biological factors of mental health refer to
Genetic predisposition
Brain structure and functions
What are 4 key components of ASD
Socialisation
Narrow interests
Imagination
Sensory
When were mental health difficulties first reported
Kanners first clinical report of 1943
What conditions did Kanners note in 1943
Anxiety and fear
Depression
What symptom is shared between anxiety and sameness
Insistence of sameness
What is the typical age to be diagnosed with ASD acording to Howlin 1999
5 years
When do people get diagnosed with AS
11 years or adulthood
Who reported a lack of support post diagnosis for children and adults
Crane 2015
Who reported Bullying and peer victimisations
Shatyermman 20017
What do those who transition into adulthood with ASD/AS report
lack of support services health and social difficulties poor quality of life low occupational achievement social exclusion and isolation
What social challenges do those with ASD face
Difficulty recognising others emotions, interpreting and predicting behaviour and responding accuratly
True or false ASD are harder to read according to Sheppard 2017
true
What could the social challenges those with ASD face contribute to
Social exclusion Sasson
What is the social challenges that those with ASD face referred to
Social challenges
What are the potential impacts of the social challenges ASD face
social isolation
Loneliness
Those with high autistic traits more likely to experience thwarted belongingness
What conditions is ASD associated with
Depressio and self harm
What is the name of the ASD coping strategy in social situations
Camoflauging
What gender is camouflaging more common in
Women
What does camouflaging lead to
Under diagnosis Miss diagnosis Toll on mental health Loss of identity Exhaustion
Why does camouflaging occur
To help fit in in a NT society
What are the DSM criteria for depression and how many do inidivuals have to have
5 or more of the 9 Depressed mood looks of interst change in weight insomnia retardation or agitation loss of energy worthlessness impaired concentration death, suicide ideation or suicide attempts
What percentage of the UK population experience a mental health problem
23%
What is the most common mental health problem
Depression
What percentage of ASD adults meet the criteria for a psychiatric condition at some point with depression most common
79%
What is the prevalence of depression in ASD adults
30-50%
What is the prevalence of depression in ASD children
30%
Why is there believed to be such prevalence of depression in ASD
Social Isolation
Unemployment
Loneliness
Awareness of own shortcoming and struggle
What style has been suggested by Cassidy as to why prevalence of depression is so high in ASD
Cognitive style
What aspects of cogntive style are believed to influence depression prevelance
Inflexible thinking
Memory biases
What are the issues preventing effective diagnosing of depression in ASD
Overlap of symptoms - diagnostic overshadowing
Lack of ASD relevant terms
Cognitive style affecting interpretation of questions
Who conducted a study into the psycho-socail factors of ASD
Jackson 2016
What did Jackson 2016 find regarding the psycho-social factors of ASD
Self-reported autistic traits associated with current self reported depression, significantly mediated by difficulties in social problem-solving skills
What are the impacts of depression in ASD
Over 90% of those who commit suicide where diagnosed with depression
What level of risk of suicide are those with ASD
Significantly increased risk
Out of 347 newly diagnosed AS what percentage had suicidal idealisation
66%
Out of 347 newly diagnosed AS what percentage had sucidice plans or attempts
35%
What percentage of 347 people newly diagnosed with AS had depression
31%
Who suggested that Autistic traits and depression risk factors for suicidality
Cassidy 2014
What did the large population study of Sweden find
Adults with autism significantly more likely to die by suicide than the general population
What did the Swedish study find where the biggest risk factors for sucide
female, ASD without ID and depression - opposite to general population
What gender are mental health problems and suicidality highest in ASD
Women
What does a lack of social support in ASD incerase
Depression and suicidal ideation
Hedley 2017
What do feelings of loneliness increase
Depression and thoughts of self harm
Hedley 2018
What were the 2 factors Pelton believed effected capability for suicide
Thwarted beloning
Perceived burdemoness
Are the two factors suggested by Pelton linked to ASD
ASD traits predict both factors
What is ASD associated with in young adults according to Pelton and Cassidy
Depression, suicidality, perceived burdensomeness, and thwarted belongingness
What are the two areas that cause challenging measurement for ASD mental health diagnosis
Cognitive and behavioural
What are the cognitive aspects of ASD
Alexthymia
ToM
Literal interpretation
Reduced flexibility in thinking
What ASD symptoms overlap with depression criteria
Social withdrawal
Difficulties with sleep
Flat affect
Reduced eye contact
What does overlap of ASD and depression criteria lead to
Diagnostic overshadowing
Who identified a lack of ASD specific items
Stewart et al. 2006
What makes a high quality assessment tool
Structural validity Internal consistency Hypothesis testing Criteron validity Content validity Reliability
Who conducted a systematic review of assessed quality of previous studies using research tool COSMIN
Cassidy 2018
What did Caassidy 2018 find
Only 1 low quality study assessing the criteria in ASD adults
What were Cassidy’s 2018 conclusions
Weak evidence compared to general population
Gothman 2015 found mild-moderation correlation with other measures and what
Clinical diagnosis of depression
In the general population all the symptoms in the DSM come from where
One latent variable
Depression assessment measurement properties of mental health assessment tools are likely different in what
ASD compared to the general population
What is key in diagnosis
Content validity
What needs to be included in the depression assessment in ASD
to include autism specific items which capture unique presentation of depression in autism
What questions could be added to the ASD depression criteria
Sensory sensitivity and camouflaging
What hypothesis testing needs to be done on ASD
Check that autistic people with depression score higher than autistic people without depression
Compare structural validity and internal consistency of original to adapted measures
What criertion validity needs to be checked in depression assessment
Tricky – what is the ‘gold standard’ to compare?
Could compare performance of original and adapted tools against clinical assessment
What is needed for depression
Adapted assessments needed and currently being developed
What are anxiety and worry associated with
Restlessness or feeling on edge Easily fatigued, difficulties concentrating Irritability Muscle tension Sleep disturbance
How does anxiety manifest itself in ASD
Associated with intolerance of uncertainty, RRBs and sensory processing
What could the associated anxieties affect the perception of
Anxiety in ASD
What type of difficulties are a core feature of ASD and RRbs and anxiety
Sensory difficulties
What is social anxiety defined as
Fear of general population negative evaluation
What does social anxiety of ASD refer to
Fear of violation of logical rules or unpredictability of social situations
What is the tool adapted for children with ASD being tested for anxiety
Revised Child Anxiety and Depression Scale (RCADS)
What did Rodgers study find
Established a factor structure in anxiety ASD assessment
What is BPD
Bipolar disorder
How many criteria are required to be diagnosed with BPD
5/9
What are the symptoms that overlap between BPD and ASD
Social difficulties
Emotion regulation difficulties
Frequent suicidal gestures
What may someone with BPD present as
Can appear to have very unstable and chaotic lifestyle – frequent changes or inappropriate friendships
What factor of ASD may lead to difficulties diagnosing BPD
Camouflaging
What gender is BPD more commonly diagnose in
Females
What gender is ASD underdiagnosed with
Females
High prevalence of suicidality / self injury in particularly in what gender of ASD
Females
What may the under diagnosis of ASD in females and over diagnosis in BP be attributed to
Potentially lead to misdiagnosis of autistic females as BPD or miss co-occurring conditions
What percentage of BPD meet criteria from ASD
15%
What were patients with BPD and ASD at significant higher risks for
Suicide attempts
Lower self image
What level of ASD traits do BPD have according to Dudas
Elevated
Those with combined BPD and ASD have the highest what
ASD traits
Given the similarities between BPD and ASD what is understandable
Misdiangosis
What defines an eating disorder
Persistent restriction of energy intake leading to significantly low body weight
Either an intense fear of gaining weight or of becoming fat, or persistent behaviour that interferes with weight gain
What is body dysmorphia
Disturbance in the way one’s body weight or shape is experienced undue influence of body shape and weight on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.
What does someone with Anoreixa typical presented as
Significantly underweight
What does someone with bulimia present with
Recurrent episodes of binge eating followed by inappropriate compensatory behaviour (for example, vomiting, laxative use, excessive exercise) in order to prevent weight gain
What does ASD primarily effect in the early development
Social function and fleixibility
When do Eds primarily affect eating behaviour
Onset in adolescent or adulthood
What gender are Eds more common in
Women, but ASD under diagnosed in males
ID more prevalent in what conditions, and less prevalent in what conditions
Prevalent in ASD
Not prevalent in EDs
Who is concerned that ASD could increase risk of EDs
Gilberg 1983
Why does Gilberg think ASD increases EDs risk
recurrent episodes of binge eating followed by inappropriate compensatory behaviour (for example, vomiting, laxative use, excessive exercise) in order to prevent weight gain
What is the prevalence of EDs in ASD samples
8-37%
What does the precentages of EDs and ASD show
Supporting evidence for increased prevalence of autism in ED samples
Are the Eds behaviours being picked up on not truly autistic?
NO
What are the co-mobid symptoms with ASD and EDs
OCD, depression, anxiety and starvation
What does starvation do
Temporarily increases rigidity and obsession with food
How can EDs be mistake for ASD
Narrow obsessive with food interest, sensory difficulties eating , social difficulties certain order or touch, rituals)
Mandy 2015 used what standard of assessment in ASD ED research
Gold standard diagnostic assessment of 10 EDs
What did Mandy 2015 attempt to do
Disentangle superficial or real autism in those with ED
Out of the 10 EDs how many did Mandy 2015 find matched the criteria for ASD
5
Why did 5 EDs match the criteria for ASD
Difficulties since childhood prior to the onset of ED
What does Mandy’s 2015 suggest
Not an effect of starvation
What is the most common area of concern for adults first diagnosed with ASD
Mental health
What did Raja 2014 find
Many psychiatrists however are not trained in autism or developmental conditions
What does few psychiarities being trained in ASD lead to
Autistic adults slipping through the net
Research showed that young ASDs struggled to get a MH diagnosis and treatment true or false
True
Why would ASD have difficulties evaluating mental health
Alexythymia
Reports of stigma
Sever obstacles
What can ASD effect in treatment
Ability to
engage with traditional
treatments
What type of therapy required high degree of emotional literay
CBT
What therapy would ASD find difficult
CBT
What makes ASD and anxiety hard to treat
High sensory sensitivity
What can ASD adults benefit from
Psychological therapy to treat mental health difficulties such as anxiety, but it takes much longer
What technology is being used to treat anixiety in ASD
VR
Who used VR to gradually expose individuals (9) to specific phobias
Maskey 2014
How many ASD did Maskey treat
8/9 able to tackle phobia
Do not assume that mental health problems are part of autism
true or false
True
Do not assume that it is not possible to treat mental health conditions in autism
true or false
True
