mental health q's Flashcards
what does DSM stand for?
diagnostic and statistical manual
what is the DSM?
The major reference used by mental health professionals in the United States and Canada to diagnose people with psychological disorders
what might other countries use instead of the DSM?
the International Classification of Diseases and Related Health Problems (ICD)
what does the DSM-5-TR not address?
the fact that a number of psychological disorders are expressed differently in older adults, particularly those who also have medical conditions
- doesn’t consider cultural differences
- no middle ground for diagnoses (you have it or you don’t)
why is anger not debilitating for young-older adults?
why is sadness adaptive for old-old adults?
what are the stages of ageism and it’s effects on service provision?
1) assume aging is associated with depression
2) react to clients as to their own family members
3) believe that older adults don’t need special treatment
4) set stage for harmful self-stereotypes
what are the symptoms for major depressive disorder (MDD)?
- an extremely sad mood that lasts most of the time for at least two weeks and is not typical of the individual’s usual mood
- and/or a loss of interest or pleasure in most activities for most of the day
what are the ‘traditional’ symptoms for MDD?
- dysphoria (sad mood)
- guilt
- low self-esteem
- suicidal thoughts
T/F: Older adults acknowledge symptoms of depression just as easily as younger adults do.
FALSE
what are some contributors to depression in later adulthood?
- mobility limitations
- hypertension
- sensory impairments
- pain
- stroke
- lack of vitamin D
- metabolic syndrome and diabetes
- sleep disturbance
- tooth loss
T/F: mental health illness is a risk factor for suicide.
TRUE
what are the types of intervention for depression/anxiety?
medical intervention and psychotherapy
what are the medical interventions for depression?
- psychotherapeutic medication
- electroconvulsive therapy (ECT)
describe psychotherapeutic medication
attempts to reduce an individual’s psychological symptoms
describe electroconvulsive therapy (ECT)
an electric current is applied through electrodes attached across the head
what are the types of psychotherapy for treating depression?
- cognitive behavioural therapy (CBT)
- problem solving therapy (PST)
describe cognitive behavioural therapy
the clinician encourages clients to develop more adaptive behaviours and ways of thinking about their experiences
describe problem-solving therapy
patients are taught systematic ways of identifying and solving their actual life problems
what is rational suicide?
what are some risk factors for suicide (other than mental health illness)?
- marital breakdown
- financial hardship
- deteriorating physical health
- a major loss
- lack of social support
where does suicide rank in leading causes of death in Canada?
9
what are the gender breakdowns of suicide?
men are 3x more likely to commit suicide than women
T/F: married individuals are more likely to commit suicide than widowers
FALSE.
widows are more likely to commit suicide
what age group is most likely to commit suicide?
ages 45-49
when do suicide rates decrease and increase?
rates tend to decrease around ages 65-69, and then increase again after
what extent of depressive symptoms do older adults tend to have (majority)?
mild to moderate symptoms of depression
what is Bipolar Disorder?
a psychological disorder where people experience one or more manic episodes in which they feel elated, grandiose, expansive, and highly energetic
how many types of bipolar disorder are there?
2
bipolar I disorder
bipolar II disorder
describe bipolar I disorder
individuals may or may not have experienced a period of significant depression along with being manic for at least a week
describe bipolar II disorder
individuals may have experienced depression and at least one ‘hypomanic’ episode, in which manic symptoms lasted for less than a week
what are the rates of bipolar disorder in older adults?
it is relatively low
- affects 0.5-1.0% of people 65+
what are the rates/prevalence of anxiety disorders among older adults?
17.2% prevalence (overall)
(#1) agoraphobia: 4.9%
(#2) panic disorders: 3.8%
(#3) animal phobia: 3.5%
(#4) general anxiety disorder (GAD): 3.1%
(#5) social anxiety disorder: 1.3%
what describes anxiety disorders?
a sense of dread about the future, which often makes the person go to great-lengths to avoid anxiety provoking situations
what is the most highly prevalent psychological disorder (aside from substance abuse)?
anxiety disorders
what is the lifetime prevalence for anxiety disorders?
18.1%
when do prevalence rates for anxiety start to decrease?
ages 60+
which gender has a higher prevalence rate of anxiety?
women
is OCD categorized as an anxiety disorder?
no
describe obsessive-compulsive disorder
when an individual suffers from obsessions, or repetitive thoughts and compulsions, which are repetitive behaviours
describe Diogenes Syndrome
a geriatric symptom of gross neglect
includes:
- extreme self-neglect
- domestic squalor
- excessive hoarding
- lack of concern / shame
- social withdrawal / refusal of all help
describe acute stress disorder
experience symptoms of stress for up to a month after the trauma
describe post-traumatic stress disorder (PTSD)
symptoms that persist for more than a month after the trauma
describe late-onset stress symptomatology (LOSS)
aging veterans who were exposed to stressful combat situations in …(?)
describe self neglect
the inability to attend to one’s health, hygiene, nutrition or social needs
–> prevalence increases with age
–> associated with: depression, dementia, mental illness, substance abuse, frailty, vision impairments & elder abuse
what are the subtypes of Diogenes Syndrome?
primary (50-70%)
secondary (30-50%)
what are the differences between primary and secondary subtypes of Diogenes Syndrome?
primary:
behaviour is intentional and NOT related to mental illness
secondary:
behaviour is NOT intentional and IS related to mental illness (ex. depression, schizophrenia, dementia, alcoholism)
What are some indicators that an individual has Diogenes Syndrome?
individual is:
- filthy / unkempt
- neglected feet
- poor dentition (or no teeth)
- bad smell
- family raises issues of hoarding or self-neglect
what is DDx ? (on gross feet slide)
what are the forms of financial abuse in which older individuals are at-risk for?
- lottery scams
- grandparent scams
- romance scams
- Internal Revenue Service (IRS) imposter scams
- tech support scams
- securities fraud
- health care fraud
define elder abuse
a large category of actions taken directly against older adults that inflict physical or psychological harm
what are some signs of elder abuse?
- depression
- confusion
- withdrawn behaviour
- isolation from friends & family
- unexplained injuries
- appearing in need of care
- having bed sores
describe substance use disorders
involves the use of alcohol and/or drugs to a degree that causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home
what is the prevalence of Canadians, aged 15+, having a substance use disorder in their lifetime?
1 in 5
what is the lifetime prevalence for substance use disorders?
21.6%
what is the most common type of substance use disorder?
alcohol abuse
are older adults at any particular risk for substance use disorders?
yes, more at risk for prescription drug abuse
describe impulse control disorders
failure to resist a temptation, urge or impulse that may harm oneself or others
which psychological disorders include ‘impulsivity’ as a feature?
- substance abuse
- ADHD
- mood disorders
- anti-social personality disorders
what are the 5 behavioural stages that characterize impulsivity?
(1) an impulse
(2) growing tension
(3) pleasure from acting
(4) relief from the urge
(5) guilt (may or may not arise)
what are some forms / types of impulse control disorders?
- pathological gambling
- pyromania
- kleptomania
- compulsive shopping
which neurotransmitter might be related to impulse control disorders?
dopamine
what is the prevalence of gambling addiction among adults 55+ (in the 2018 study)?
20.3% with moderate gambling problems
6.9% with severe gambling problems
how much time & money did participants in the 2018 study dedicate to gambling?
time: 135 hrs / year
money: $140 / visit
define professional geropsychology
the application of gerontology to the psychological treatment of older adults
define Pikes Peak Model of Geropsychology
a set of competencies that professional geroplychologists are expected to have when working with older adults
define psychological assessment
a procedure in which a clinician provides a formal evaluation of an individual’s cognitive, personality, and psychosocial functioning
what should clinicians do when conducting psychological assessments?
they should tailor each assessment to the physical and cognitive needs of the client
–> ex. for older adults, consider sensory, motor, and cognitive accommodations
define clinical interview
a series of questions that are administered in a face-to-face interaction with the client
define mental status examination
assesses a client’s current state of mind
define orientation (in terms of psychological assessment)
examines whether the client knows where they are (place), what time it is (time), and who they are (person)
define geriatric depression scale (GDS)
individuals answer true-false questions about their depressive symptoms
what is the centre for epidemiological studies depression scale (CES-D)?
a 20-item questionnaire that screens for depressive symptoms
what are the different models of psychotherapy with older adults?
psychodynamic:
–> inner conflicts, attachment issues, life review
behavioural:
–> change the reinforcements for behaviour
cognitive:
–> focus on dysfunctional thoughts & changing them
cognitive-behavioural:
–> change thoughts and behaviours
interpersonal:
–> cognitive methods and social skills
integration:
–> the combination of all approaches
which gender requires more social support and why?
women require more social support because of their multiple roles in society
–> although women are also more likely to give up on supports
what are the buffering effects of social support?
although won’t keep stressors from entering one’s life, it will provide protection against the harm they do
how can social support be negative?
what role does optimism and pessimism play as a protective factor?
what evidence exists that social support is a ….?
