Mental Health and Wellbeing Flashcards
What i WHO’s definition of Health?
a state of complete physical, mental and social well-being’
What is health psychology?
A branch of psychology addressing factors that influence well-being and illness
How did Matarazzo define Health Psychology? (1980)
the aggregate of the specific educational, scientific and professional contribution of the discipline of psychology to the promotion and maintenance of health, the promotion and treatment of illness and related dysfunction
What is a stressor?
demands made by the internal or external environment that upset balance
Give examples of types of stressors
Micro-Stressors, Negative Life Events etc.
Acute Stress/ Chronic Stress
What are the components of the physiological stress response?
Hypothalamus, Pituitary Gland, ACTH, Adrenal Glands, Cortisol, Aldosterone, Epinephrine.
What is Allostasis?
a physiological and psychological mechanism that promotes balance, changing through variation rather than similarity
Which physiological mechanism promotes balance in the body through single point tuning (eg blood pH)
Homeostasis
What is the difference between allostasis and homeostasis
Homeostasis makes smaller, more subtle changes, to remain around the same level (eg blood temperature). Allostasis makes more radical and short term changes to maintain internal viability
Who coined the term Allostsis?
Sterling and Eyer (1988)
What is Allostatic load?
Allostasis creates ‘wear and tear’ and a body can only handle so much of this
What is allostatic overload?
The bidy has overreached its capacity, and so there can be intense pathophysiological effects
What example of allostatic load did Donoghue research (2016)?
Older adults study showed that exposure to recent adversity was associated with doubling of the odds of depression
Why might chronic stress lead to more frequent illness?
As cortisol inhibits the immune system
What did Kieholt-Glaser et al (1984) find about stress and the immune system
blood samples taken from the first group (before the exam) contained more t-cells compared with blood samples taken during the exams
Who introduced the concept of homeostasis and Fight or Flight?
Walter Canon
What problems are there with the fight or flight response?
Androcentric, doesn’t take into account psychological factors and is described as constant regardless of stressor
What did Hanse Seyl (1976) find about the body’s resistance to stress?
Resistance is low at first (S1: Alarm) Increases in S2, but exhaustion from continued resistance will drop resistance to stress
What is the transactional model of stress?
A model where stress is both a stimulus and a response, seen as a person-situation interaction
What is cognitive appraisal?
The stages passed through when deciding the nature of a stressor
What are the stages of cognitive appraisal?
Primary Appraisal- Is it a threat?
Secondary Appraisal- Can I cope with this?
If a stressor is deemed to be ‘copable with’ in the secondary appraisal, what occurs?
Coping methods are deployed, which then lead to outcomes, e.g. good mental health
How did Lazarus and Laurnier (1978)
define coping?
Constantly changing cognitive and behavioural efforts to manage specific internal and/or external demands that are appraised as taxing or exceeding the resources of the person
Who investigated the dynamic nature of coping, involving appraisal and reappraisal of a situation?
Lazarus and Folkman (1987)
What are the main elements of coping?
Coping is a process of constant evaluation of the success of one’s strategies
Coping is learned as one encounters situations
Coping requires effort
Coping is an effort to manage. Success is not contingent on mastery, just good enough
What is problem focused coping?
Coping that targets the causes of stress in practical ways, consequently directly reducing it
Examples of Problem Focused Coping?
Planning, active coping and problem solving, Exercising restrain.
Positive of Problem Focused Coping?
+ Best choice in general, provides long term solution
Negative of Problem Focused Coping
Often little help on problems that ‘can’t’ be fixed, eg bereavement
What is Emotion Focused Coping?
Trying to reduce the negative emotional responses associated with stress
Name negative emotional responses associated with stress
Embarrassment, fear, anxiety, depression
What type of coping is Drug Therapy?
Technically Emotion Focused, as it does not tackle the stressors, only the symptoms
Examples of Emotion focused coping?
Positive reinterpretation, Acceptance, Controlling feelings
What did Penley, Tomaka and Weibe (2012) find about emotion focused coping?
In general, EF coping users reported poorer health outcomes, less effective than problem focused
How might Seeking Social support lead to coping?
provide EF coping through Emotional Support, can promote PF coping, proving tangible solutions
Which coping strategy is best to use?
As coping is a dynamic process, affected by dispositional and situational factors, both can be appropriate
Several studies have shown what about trauma disclosure?
In students, disclosure has been related to enhanced immune function and 50% less visits to campus health services
WHat did Ptacek et al find about gender and coping? (1992)
Men are more likely to use PF coping, women more likely to seek social support and use EF coping
What did Folkman and Lazarus find about gender and coping? (1980)
no gender differences in coping strategies
What did Coan et al (2006) find about social support?
women exposed to threatening stimuli had reduced fear activation when holding their spouses hand (fMRI)
What has been found about the effects of mindfulness?
Short term effects have been established
Good comparison rates compared to CBT
Long term studies needed
What did Ellis (1962) believe was the root of most maladaptive feelings?
Irrational core beliefs
Name some of Ellis’ irrational core beliefs? (1962)
The idea that one should be thoroughly competent at everything.
The idea that is it catastrophic when things are not the way you want them to be.
The idea that people have no control over their happiness.
The idea that there is a perfect solution to human problems, and it’s a disaster if you don’t find it.
Name a few conditions where mindfulness has been shown to have effects
Cancer, Psoriasis, Insomnia, Diabetes
What is Somatic Relaxation Training?
Progressive muscle relaxation, slowly tensing and then relaxing each muscle group individually, toe to head
What is cognitive relaxation?
Transcendental mediation (repeat a mantra), mindfulness meditation - focus on thoughts and sensations
What are Health Behaviour theories?
Processes that underlie behavioural change, usually to a more healthy behaviour
Who suggested the theory of planned behaviour?
Icek Ajzen, 1985
What does the theory of planned behaviour suggest?
A person’s intention (motivation behind a behaviour) is determined by three factors
What are three factors in TOPB that affect behaviour?
Attitude towards the specific behaviour
Subjective norms
Perceived behavioural control.
Who suggested the Transtheoretical Model of Behaviour Change?
(Prochaska and DiClemente, 1982)
What are the stages of the TTMBC
Pre-contemplation Contemplation Preparation Action Maintenance
What is Pre-contemplation in TTMBC?
The stage where you don’t intend to make a change
What is Contemplation in TTMBC?
The stage where you are considering a behavioural change
What is preparation in TTMBC?
The stage where small changes are made
What is action in TTMBC?
the stage where you actively engage in a new behaviour
What is Maintenance in TTMBC?
Sustaining achanged behaviour over time
What are behavioural beliefs?
Beliefs over the importance of an issue and whether behaviour will be effective
What are Normative beliefs?
Thoughts on how others will perceive behaviour
What are control beliefs?
beliefs in your self efficacy, ability to carry out a behaviour
What did O’connor (2006) find about TBP as a predictor of behaviour?
Self-efficacy, attitude and descriptive norm were all better predictors of self harm and suicidality than depression
What criticism is there of the Theory of Planned Behaviour?
There is no clear order or causality direction
How might TTMBC be used to encourage healthy behaviour?
Providing clear nutrition information can make pros and cons more clear in the contemplation stage
Who created the cognitive-behavioural model of relapse?
Marlatt and Gordon, 1985
What are the stages of the model of relapse, if relapse is unlikely?
Ineffective coping response. decreased self-efficacy. initial use of substance. Abstinence violation effect. Increased probability of relapse
What treatments are there for behavioural change?
– Aversion therapy Relaxation and Stress management training – Self-monitoring procedures – Coping – Counselling – Strengthen change procedures
What are the three definitions of abnormality?
Statistical Infrequency
Deviation from social norms
Failure to meet criteria of ideal mental health
What did Rosenthan (1973) find in their study on mental institutions?
Healthy patients would be admitted for schizophrenia based off ONE symptom, with other symptoms interpreted as pathological
What happened to the confederates in Rosenthan (1973)?
All but one of the confederates were falsely diagnosed as having SZ
What is Schizophrenia?
A mental disorder that leads to symptoms such as hallucinations, delusions, speech poverty and avolition
What is the incidence rate for schizophrenia?
1-2%, equal in males and females but tends to be later onset for females, similar frequencies across the globe
What are the positive symptoms of Schizophrenia?
Delusions, eg delusions of grandeur, thought insertion, broadcast etc. Paranoia, Hallucinations. Disorganised behaviour and speech
What are the Negative symptoms of Schizophrenia?
Alogia (speech poverty), impaired social interactions, Apathy (lack of interest in goal-orientated activities. Anhedonia
What is the relationship between schizophrenia and suicide?
10% death by suicide, 60-80% ideation. Risk higher for males in social isolation. rarely due to command hallucinations
What did Gottesman (1987) find about twins with SZ?
The concordance rate between MZ twins is higher than DZ, at 44.3% and 12.08% respectively
The concordance rate for Schizophrenia in MZ twins is only 44.3% (Gottesman, 1987). What does this suggest about the causes of SZ?
They are both genetic and environmental. If the causes were entirely genetic the concordance rate should be 100%
What are the types of Schizophrenia?
Disorganised (hebephrenic): disorganised, bizarre behaviour
Catatonic: excitement, energetic, vs catatonic immobility.
Paranoid: delusional
Undifferentiated: psychotic symptoms are present but the criteria for paranoid, disorganized, or catatonic types have not been met
Residual: positive symptoms present at a low intensity only
Why can labelling of mental disorders be detrimental?
Labels can : reduce responsibility, create a self-fulfilling prophecy, and generate stigma
Who coined the term Schizophrenia?
Bleuler (1911)
What is the dopamine hypothesis?
The theory that abnormal levels of dopamine lead to the symptoms of SZ
What is Hyperdopaminergia?
Excess of dopamine in the sub cortex
What might an excess of dopamine receptors on broca’s area be linked to SZ?
It may explain issues with speech, or auditory hallucinations
What is Hypodopaminergia?
Low levels of dopamine in the cortex, low levels in the prefrontal cortex (decision making), may be responsible for negative symptoms such as avolition
WHat did Randrup and Munkvad (1966) find about dopamine and schizophrenia?
WHen rats were administered with L-Dopa, there showed SZ symptoms. When dosed with anti-psychotics, symptoms wwere reduced
What did Randrup and Munkvad’s 1966 study suggest?
SZ symptoms are similar to dopamine action produced by cocaine and amphetamines, anti-psychotics may reduce dopamine action?
What did Berman et al find about SZ and neural correlates?
in MZ twins discordant for SZ, there were no differences in brain activation at rest, but during a card sorting activity, SZ twin showed reduced pre-frontal cortex activity
What did Hollingshead and Redlich (1954) find about the sociopsychological ‘causes’ of schizophrenia?
study in Connecticut. SZ 2x higher in lowest social class than second lowest.
What is Expressed Emotion?
The level of emotion, particularly negative, in families.
What did Brown (1966) find about SZ and EE?
Expressed Emotion is primarily an explanation of relapse, but combined with the D-S model can explain triggering of SZ. (Brown 1966)
What did Reulbach et al (2007) find that supports the diathesis-stress model of schizophrenia?
onset of SZ after holocaust. Significantly ass. With highest level of persecution (P<0.001).
What are the symptoms of major depression?
Profoundly sad mood over weeks/months Loss of interest in activities and relationships (Anhedonia) Disturbance of appetite, sleep Suicidal ideation Possibly delusions
What disorders/symptoms are often co-morbid with depression?
Anxiety, panic attacks, self-harm, suicidal behaviour, substance abuse, personality disorders, somatic symptoms
Which sex reports major depression more?
Women - 21-22%, Men - 13%
What is bipolar disorder?
A disorder with both stages of depression (similar to major depression) and periods of elation
What characteristics are common in ‘manic’ episodes?
Elation, Hyperactivity, Impractical flight of ideas, distractibility, inappropriate/intrusive thoughts, inflated self esteem, less need for sleep
How many people are affected by bipolar disorder?
approximately 1% of the population
What did O’Connor (2008) find about impaired future thinking?
positively correlated with suicide risk. self harm and suicide attempts best pridictor of suicide
What does cognitive therapy aim to do?
to identify and monitor negative thoughts, recognise their effects on feelings and substitue them for more positive ones
What is CBT?
Cognitive Behavioural Therapy, Cognitive therapy with a behavioural aspect involved.
What theory about depression did Seligman (1974) propose?
Learned Helplessness. Feelings of uncontrollability lead to passiveness in the face of negative events and emotions
What are the three aspects of Beck’s cognitive the
Cognitive Triad
Schemata
Cognitive Bias
What is the Cognitive Triad?
Negative thoughts towards the self, the world and the future.
What are Negative Schemata?
Where events are interpreted through a negative ‘lens’, maintaining the cognitive triad
What is cognitive bias?
Faulty processing of information, arbitrary inference, personalisation, overgeneralisation
What does Beck’s depression inventory measure?
acts as a quantitative measure of depression severity
What are some statistics on the frequency of suicide?
1m commit suicide each year. Failed attempts 10-20x higher. 2nd highest leading cause of death 18-24 year olds. Women attempt more. Men more likely to die.
15% clinically depressed will commit suicide
SZ major risk factor
Suicide not always in deepest depression
Anxiety comorbidity increases risk
LGBT men at higher risk
What are the two main parts to OCD?
obsessions - intrusive thoughts
compulsions - actions to diminish these thoughts, repeated.
What is Trichotillomania?
Compulsive hair pulling
What are the two types of trichotillomania?
Automatic - subconscious
Focussed - conscious, often in response to negative mood states
What is Dermotillomania?
Recurrents skin picking, resultant in lesions
What are the parameters to be diagnosed with dermotillomania?
Clinically significant distress/ impairment, attempts to stop, not better explained by another disorder
Why might trichotillomania etc not be in the same category as OCD?
No intrusive thoughts
sometimes pleasurable
anxiety often missing
What is psychoanalysis?
A therapy designed to gain insight into unconscious conflict, resolve them and reconstruct personality
Who invented psychoanalysis?
Freud
What techniques have been used as part of psychoanalysis?
Hypnosis, Free association, Dream analysis, Interpretation and denial, Reaction, resistance and transfer.
Who suggested Holistic Psychology and Client centred therapy as a treatment?
Rogers, 1940s-50s
What is the theory behind Client Centred Therapy?
Over dependence on acceptance of others, leads to incongruence, affecting personal growth
What are the goals of client centred therapy?
Congruence between experience and self-concept. No tangible goals set, unconditional positive regard from therapist.
Which psychologists are linked to the development of behavioural therapy?
Eysenk, Skinner, Wolpe.
What therapy for phobias is a form of behavioural therapy?
Systematic Desensitisation
What did Gilroy (2000) find in his study of systematic desensitisation for those with arachnophobia?
Systematic desensitisation reduced fear reaction, more than a relaxation placebo. Live exposure and vicarious exposure both successful, fear was still reduced 33 months later
What did Eysenck (1952) argue about insight therapies?
that they were ineffective (but later studies showed they can have effects)
Name some characteristics of Gestalt therapy
Belief people are innately ‘good’
Concentrate on whole person, and present, not past
Empty chair technique
role therapy
What is aversion therapy?
Classical conditioning, using an averse stimulus, to associate with a bad habit
What is Rational emotive therapy?
Therapy based of Ellis’ ABC model, newer versions (REBT) include behavioral elements
What does ABCDE stand for in Ellis’ ABC model
A - Activating Event
B - Belief system responsible from A to C
C - Emotional/ Behavioural Consequence
D - Disputation where irrational beliefs are challenged
E - Effects or Outcomes
What is Psychopharmacology?
Use of drugs in treatment
What drugs are used to treat anxiety?
Tranquilisers, Benzodiazapines (Xanax, Valium, Lithium)
Generalised Anxiety Disorder - drug treatment?
Anti-anxiety drugs
Schizophrenia - drug treatment?
Antipsychotics, Eg Chlorpromazine, Clozapine etc
What is Electro-Convulsive Therapy?
A small electric current passed through two electrodes on the scalp
What is Psycho-surgery?
Removal or destruction of brain tissue to improve psychological wellbeing
