Mental Health remaining

Question 1

What is the issue with language in mental health conditions

Answer 1

The language that we use can actually perpetuate stigma. Especially if our language suggests certain stereotypes associated with a certain mental health condition –> makes people feel more judged?

Question 2

What were mental health conditions referred to before

Answer 2

Abnormal psychology, however, this was changed because it suggests mental health issues is abnormal, discouraging people from speaking up

Question 3

What is psychology

Answer 3

The scientific study of behaviour, emotion and cognition (and the potential relationship between these factors)

Question 4

What is abnormal psychology

Answer 4

Scientific study of abnormal behaviour, emotions and cognitions

Question 5

What is psychopathology

Answer 5

Psyche = mind, pathology = illness/disease

Study of mental illness, including classification, causes, development, treatment and outcomes

Question 6

What is the empirical method

Answer 6

any procedure for conducting an investigation that relies upon experimentation and systematic observation rather than theoretical speculation.

It is used at different levels of mental health such as; classification/diagnosis, causation, treatment

Question 7

Explain why empirical method might be used for describing mental health

Answer 7

To define MHC, we need to tell what is normal/healthy vs abnormal/unhealthy –> we need an empirical method of approaching this

Thus, we might try to see if there are a cluster of symptoms associated with a certain illness

Question 8

Explain why empirical method might be used for identifying the causation of mental health

Answer 8

Causes of MHCs is complex
Involves interaction of biology, individual psychological factors, upbringing, social environment

Empirical method required to narrow down the influence of each on MHC

Question 9

Explain why empirical method might be used for treatment of mental health

Answer 9

Critical for understanding then treating MHCs

Scientific method used in treatment through RCTs to determine if a treatment is valid (control groups, manipulations etc), placebo effect

Question 10

Understand and explain key differences between “normal” and abnormal behaviour

Answer 10

Abnormal refers to anything whish isn’t normal –> but then what isn’t normal? (the line between the two is quite blurred)

Hard to determine as well because mental illness is subjective and varies across cultures, times etc

However, the ‘3D’s’ would help with identifying what’s considered abnormal behaviour

Question 11

What are the 3D’s?

Answer 11

Deviates
Distress
Dysfunction

Question 12

Explain how deviation can be used to recognise abnormal behaviour

Answer 12

Refers to deviation from statistical norm. Often the first step in identifying normality vs abnormality.

Basically looking at behaviour which isn’t the norm, and thats the first step in potentially detecting abnormal behaviour

Howeve,r important to note that sometimes a deviation from the norm could be an exception or rarit, and whats considered normal is always culturally and time bound –> we can’t use deviation as the only factor

Question 13

Explain how distress can be used to recognise abnormal behaviour

Answer 13

This is where there is distress in oneself or others (e.g. family). Distress isn’t always necessary

However, its just when the behaviour has a negative impact on yourself and potentially others –> sign of abnormal behaviour

Question 14

Explain how dysfunction can be used to recognise abnormal behaviour

Answer 14

if mental illness causes dysfunction in person’s ability to carry out important life goals etc, it could be classified as an illness

However, some disorders might not necessarily involve dysfunction (i.e. some people with psychopathic tendencies tned to be good CEOs - functioning well in society )

Question 15

What is the biomedical model of mental illness

Answer 15

Dominant model in psychiatry and the underlying model of the DSM 5

Assumes that mental disroders can be diagnosed similar to physical illnsesses, and can be explained in terms of a biological disease process

Ultimately proposes that mental disorders are brain diseases and emphasises pharmacalogical treatments to target presumed biological abnormalities

Question 16

What does biomedical model of mental illness believe is the best way to treat mental illness

Answer 16

Treat biological deficiencies (i.e. medication or electroconvulsive therapy ECT)

Question 17

What are the criticisms/ limitations of the biomedical model

Answer 17

Need to avoid extreme reductionism (i.e. reducing the complex nature of mental health conditions into few constituents

Complexity of psychological phenomenon are impossible to explain at the neural/molecular level asw ell

Question 18

What was the psychoanalytic model of mental illness

Answer 18

Most dominant theory in the 1st half of the 2nd century. Proposed Id (pleasure), Ego (reality satisfying both id and superego) and superego(moral self). Suggested that the Id and superego were in constant conflict, and ego tries to work out and problem solve how to meet both needs

Maladjustment/mental illness occurs when there is unresolved conflicts —> anxiety –> use of defence mechanisms –> symptoms of mental illness/ suffering

Didn’t really believe in an idea of normality

Question 19

What did the treatment in psychoanalytic model of mental illness involve

Answer 19

Involves:

Building insight into unconscious processes
Developing awareness of unresolved conflict
Developing awareness of defence mechanisms

Question 20

What was the significance of the psychoanalytic model of mental illness

Answer 20

Revolutionised the concept of mental illness

Made no clear dividing line between abnormal and normall

Strong influence on early stages of DSM

Question 21

What was the criticisms/ limitations of the psychoanalytic model of mental illness

Answer 21

Lacks evidence

Not open to empirical evaluation

Unfalsifiable (unable to be proven false)

Question 22

What was the humanistic model of mental illness

Answer 22

Significant in 60s and 70s as a reaction to negativity of psychoanalytic model (which was saying that everyone was abnormal to an extent)

Core of the model is the idea that the human being is a wholly positive figure, and the goal of the hhuman is to self actualise (involves experiencing life to the fullest, living in the present, trusting our own feeligns etc) –> every human has the potential to achieve self actualisation

Suggested that maladjustment occurred when self actualisation has been thwarted - for example the enviro imposing conditions of worth on the individual or when our experiences, emotions or needs are blocked

Question 23

What is Maslows hierarchy of needs

Answer 23

Physiological needs –> safety needs –> love and belonging –> self esteem –> self actualsation

Question 24

What was treatment in humanistic model of mental illness based on

Answer 24

Involves treating people with empathy and an unconditional positive regard, and trying to help them see themselves in a positive way

Question 25

What were the critiques of the humanistic model of mental illness

Answer 25

These are important parts of therapy, but they aren’t sufficient enough (can’t just have a positive regard of them)

Difficult to research (i.e. when is self actualisation actually achievable)

Question 26

What was the behavioural model of mental illness

Answer 26

Reaction to psychoanalysis being unfalsifiable. In comparison, this involves clasasical and operant conditioning

and suggests that maladjustment occurs as a result of our learned history/associations with negative things

Question 27

What was the treatment with the behavioural model of mental illness

Answer 27

Involve varying treatments, in particular exposure therapy to help with extinction

Question 28

What were the criticisms of the behavioural model of mental illness

Answer 28

Involves the overemphasis on behavioural aspects, and often excluding cognitive and emotional elements

Question 29

What was the cognitive-behavioural model of mental illness

Answer 29

Most dominant current psychological model

Suggests that our behaviours are controlled by our cognitions, and they both work together to determine how we feel and what we do etc

Question 30

WHat does the CB model of mental illness suggest is the root cause of mental illness

Answer 30

Negative core beliefs are the root cause of mental illness.

These are long held core beliefs or udnerstandings of the world that a person holds which influences our interaction with and interpretation of the world –> automatic thoughts coming from core beliefs. It can come from early life experiences which set blueprint for how we interpret the world

E.g. loving family = im safe, im enough , im loved

unloving family = im alone, im not worth anything

It is ultimately our automatic negative thoughts which reflect our core beliefs and might appear so quickly that we don’t notice them, leading to our mental health issues

Question 31

What are some examples of cognitive distortions/ biases

Answer 31

All or nothing thinking

Mental filter

Overgeneralising

Disqualifying the positive

Jumping to conclusions

Magnification of catastrophies

Labelling

Question 32

What does the CB model of mental illness suggest treatment involves

Answer 32

Psychoeducation = teaching the people about their automatic thoughts and how to catch themselves thinking those negative thoughts

Cognitive restructuring = challenging content of negative automatic thoughts

Behavioural experiments or exposure therapy can also be used

Question 33

What were the criticisms with the CB model of mental illness

Answer 33

Too structured, which might not allow for flexibility to address unique needs

High dropout rates due to high attention needed

Oversimplifies psychological problems by focusing mainly on thought patterns and behaviours

Question 34

Explain what psychoanalytic, humanistic, behavioural, and cognitive-behavioural believe the cause of mental illness is, and how to treat them?

Answer 34

Psychoanalytic cause = repression of unresolved conflict

Psychoanalytic treatment = insight

Humanistic cause = thwarted self actualisation

Humanistic treatment = empathy,, unconditional positive regard, self discovery

Behavioural cause = learned association

Behavioural tretment = learn new associations

CB cause = negative core beliefs, biased thinking, learned associations

CB treatment = cognitive restructuring, exposure, behavioural experiments

Question 35

Describe what the DSM does/ what are its key features

Answer 35

It defines psychopathology, reflects the biological / medical model of mental illness and typically reflects the most agreed upon definitions / current consensus

Question 36

How does DSM diagnose and classify mental illness

Answer 36

Uses a categorical approach to diagnosis, where mental disorders are classified into distinct categories based on specific criteira (i.e. a set of symptoms that must be present for a diagnosis to be made)

Question 37

What are some changes which have happened in the DSM

Answer 37

Generalised anxiety disorder first introduced in DSM 3

Bing eating disorder first included in DSM 5

Asperger’s disorder removed from DSM 5

Prolonged Grief disorder removed in DSM 5

Question 38

What are the benefits in DSM approaches to diagnosis and classification of mental illness?

Answer 38

Provides a standardised set of criteria for diagnosinng mental disorders which promotes consistency across different practitioners and settings

reflects empirical research and is often updated to reflect understandings of mental health

Supports treatment planning

Improves communication between researchers and healthcare professionals

Question 39

What are the limitations in DSM approaches to diagnosis and classification of mental illness?

Answer 39

Labelling/stigma

Over medicalising reasonable reactions to stressful situations

Problems of validity, reliability and ambiguity

Reductionism (oversimplifying complex mental health issues)

Question 40

What are the similarities in DSM approaches to diagnosis and classification of mental illness (with ICD - international classification of diseases)?

Answer 40

Both provide standardised criteria for diagnosing mental disorders and are widely used by clinicians worldwide

Both based on empirical research and periodically upadtes to reflect scientific knowledge

Question 41

What are the differences in DSM approaches to diagnosis and classification of mental illness (with ICD - international classification of diseases)?

Answer 41

DSM is more detailed and focussed on psychiatric diagnosis, while ICD has a broader scope, including all diseases and health conditions

ICD uses a dimensional approach –> more flexible categories compared to DSM’s more rigid approach

Question 42

What is anxiety

Answer 42

Anxiety is when an individual experiences intense, excessive and persistent worry and fear about everyday situations

This is typically activated in response to a perceived threat

Experience of anxiety is the same in normal anxiety and abnormal anxiety (severe, often and excessive)

Question 43

Why does anxiety occur

Answer 43

Activation of physical, cognitive and behavioural systems

Question 44

Explain the physical elements of anxiety (i.e. physical symptoms)

Answer 44

Increased heart rate and blood pressure

Stress hormones and diff neurotransmitters being released

Breathing speeds up to get more O2 for muscles

Saliva production reduces

Body tenses up

We sweat

Digestion slows down as blood flows away from stomach to muscles

Question 45

Explain the cognitive elements of anxiety

Answer 45

Refer to how you pay attention, what you attend to, and your interpretations of the situation / object / person

1) perception of threat

2) Attentional shift towards threat

3) hypervigilance to source of threatening info –> difficulty concentrating on other tasks

Question 46

Explain the behavioural elements of system (i.e. coping measures)

Answer 46

Avoidance behaviours

Restlessness and fidgeting as a way of releasing nervous energy

Question 47

What is Yerkes Dodson Law

Answer 47

Suggests that there is an optimal arousal which allows for the best performance

Question 48

Explain abnormal anxiety

Answer 48

Typically characterised by overestimation of threat (excessive and disproportionate)

Perceived higher probability of a negative outcome

Perceived cost of negative outcome is often increased as well

Question 49

Differentiate between normal and abnormal anxiety

Answer 49

Normal anxiety is typically proportionate to the situation, and occurs out of an evolutionary need for survival

Abnormal anxiety is typically a lot more out of proportionate reaction/anxiety in response to a situation

Question 50

Explain key differences between DSM 4 and DSM 5 anxiety and related disorders

Answer 50

Introduction of selective mutism

Got rid of Acute stress disorder, posttraumatic stress disorder, obsessive compuslive disorder as specific disorders. Instead, they reintroduced them under umbrella terms like ‘trauma and stressor related disorders’ or ‘obsessive compulsive and related disorders’

Question 51

What is a panic attack

Answer 51

This describes a discrete period of intense fear or discomfort that appears abrupty and peaks usually within 10 mminutes

Classic symptoms of autonomic arousal (sweating, pounding heart, shaking, shortness of breath, nnausea, dizziness etc) –> could also be followed by a fear of dying, losing control, going mad etc

Question 52

What is a specifier

Answer 52

Extensions to a diagnosis to further clarify a disorder or illness. They allow for a more specific diagnosis

Question 53

What is a panic disorder? What is it characterised by?

Answer 53

This is recurrent unexpected panic attacks (unknown triggers)

At least one of the attacks was followed by 1 month (or more) of one or both of the following; persistent concern/worry about having another attack, significant maladaptive change in behaviour relative to attacks

Question 54

What are panic related behaviourss?

Answer 54

Avoidance (of situations where panic is likely and of activities that produce panic like sensations)

Escape

Question 55

What is the difference between panic attack and disorder

Answer 55

Panic attacks may be experienced in everyday situations, and fear focuses on negative evaluation by others and expected social embarassment

Meanwhile, panic disorders is when the attack itself becomes a problem, as indicated by fear of future attacks and altered behaviour in response to attacks (fear of fear)

Question 56

What are some stats about panic disorder

Answer 56

~5% of Aus has had PD in lifetime, about 3-4% in any 12 month period

Most common in females

Onset in early adulthood

Comorbidity (depression, agoraphobia)

Question 57

Describe the Clark cognitive model of panic disorder

Answer 57

1) Typically benign triggering stimulus

2) This stimulus is perceived as a threat and a sign of imminent physical or psychological catastrophe

3) Catastrophic misinterpretation

4) Anxiety response: misinterpretation —>heightened anxiety and activation of fight or flight response including release of adrenaline which intensifies the physical sensations like HR or shortness of breath

5) panic attack as these feelings are misinterpreted as a panic attack –> cycle continues

Question 58

Describe the key treatment elements for panic disorder

Answer 58

CBT: Psychoeducation, exposure and interoceptive exposure (graded exercises that induce the physical responses of a panic attack, repeated and sufficient duration, challenged beliefs about physical sensations and extinguish conditioned anxiety)

Question 59

What are the key features of specific phobia

Answer 59

A marked and consistent fear reaction to presence or anticipation of a specific object or situation

Anxiety experiences is out of proportion to the actual threat

Persistent - lasting 6 months or more

Phobic stimulus is avoided or endured with intense fear

Fear/anxiety/avoidance causes clinically significant distress or impairment in socia, occupational or other important areas of functioning

Question 60

What are some examples of subjects of phobia

Answer 60

Could include animals, blood, injections, nature etc.

Question 61

What are the potential causes of specific phobias

Answer 61

Could be due to classical conditioning (bad experience –> fear response –> phobia). However, conditioning isn’t the only cause

Some stimuli is more likely to become phobic than others (i.e. knives, guns)

Some phobias are threats to survival during evolution (i.e. phobias related to survival, such as snakes, spiders and heights are common)

Question 62

Explain the prevalence and course of specific phobia

Answer 62

COmmon in children and more intense in adults

7-9% of adults have a specific phobia

More common in females (2:1) - particularly animal, environment, situational (blood/injection/injury)

Sometimes develops after a traumatic event, observing trauma, information transmission

Can develop in childhood and adulthood as well

Question 63

What is the difference between normal fears and specific phobia as a mental health condition

Answer 63

Normal anxiety = feeling queasy while climbing a tall ladder

Phobia = avoiding climbing stairs because its tall and you’re scared of heights

Normal anxiety = worrying about taking off in a plane during a storm

Phobia = turning down a big promotion because it involves air travel

Question 64

What is Generalised Anxiety Disorder(GAD)

Answer 64

The key symptom for a diagnosis of Generalised Anxiety Disorder is excessive worrying about a variety of different outcomes (rather than about one feared outcome, as in the other anxiety disorders).

The person finds it difficult to control their worrying and experiences a number of other symptoms, such as muscle tension, irritability, or sleep problems. The worries tend to be related to everyday life, such as work, study or relationship. However, as in the case in all other anxiety disorders, the worrying is out of proportion to the actual threat involved.

Question 65

DSM 5 classification of GAD

Answer 65

Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
The individual finds it difficult to control the worry.
The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months):
Restlessness or feeling keyed up or on edge.
Being easily fatigued.
Difficulty concentrating or mind going blank.
Irritability.
Muscle tension.
Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).
The disturbance is not better explained by another mental disorder.

Question 66

Explain GAD prevalence and course

Answer 66

6.1% of people get it within their lifetime

Age of onset at around 31-39 years

Higher prevalence of females

Clinical course: most people w/ GAD dont seek help from mental health professionals, and those that do delay by over 10 years. Fluctuations in severity over time

Question 67

Explain the diagnostic features of GAD

Answer 67

Associated with 3+:

Restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance

Excessive and uncontrollable worry (about wide range of events or activities)

Constant negative stream of consciousness - tihings that could go wrong, worrying about worrying, “what if?”

Question 68

What are the features and associated thought processes of GAD

Answer 68

Excessive and uncontrollable worry, which could be based on but not limited to; professional worries, finances, personal health, world events, minor matters

The focus of worry may shift fro one concern to another. Typically the intensity/duration/frequency of worry is out of proportion to actual likelihood or impact of anticipated event

Process of catastrophising can occur automatically and quickly escalates

Associated with high trait anxiety, intolerance of uncertainty, reduced ability to tolerate distress, reduced problem solving confidence

Question 69

What is obsessive compulsive disorder (OCD)?

Answer 69

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by persistent, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that an individual feels driven to perform. OCD can significantly impact daily life and functioning, as individuals experience intense distress over their obsessions and often perform compulsions to reduce the anxiety caused by these thoughts.

A key feature is the idea of a THOUGHT-ACTION FUSION - where they may think their thoughts are more than just thoughts and instead think that thoughts = action (i.e. thinking of killing someone means you actually kiilled them)

Question 70

What are obsessions in ocd?

Answer 70

Repeated, intrusive, irrational thoughts or impulses which cause severe anxiety or distress

Question 71

What are compulsions in ocd?

Answer 71

Reptitive/ritualised behaviours or mental acts to neutralise obsessions / reduce anxiety

Question 72

What are some common compulsions

Answer 72

Washing/cleaning

Checking

Repeating

Ordering and arranging

Mental compulsions

Question 73

What are some common obsessions

Answer 73

Contamination

Symmetry/order

Doubt/harm

Forbidden/taboo

Question 74

What is the (potential) link between obsessions and compulsions

Answer 74

Can have one without the other but both are normally connected

OCD might be connected (contamination obsessions –> cleaning compulsion)

OCD might not be connected (forbidden obsessions –> cleaning compulsion)

Question 75

What is OCD commonly associated with

Answer 75

Intolerance of uncertainty

Inflated responsibility

Thought action fusion (thinking about something is as bad as doing it) (thinking abt something makes it more likely to happen)

Medical ideation (If i dont step on the cracks, I will pass the exam)

Question 76

What are the treamtnets for anxiety disroders

Answer 76

CBT, Psychoeducation, cognitive, behavioural, and biological treatments

Question 77

Explain how CBT is used to treat anxiety disorders

Answer 77

Aims to reduce threat appraisals. Involves:

Encouraging patients to have a decreased likelihood of perceived harm, encouraging patients to decrease their perceived cost of the harm. Exposure gradual is also an essential ingredient

Likelihood + cost + exposure = effective treamtent (hopefully)

Also acceptance and treatment therapy is effective as CBT

Question 78

Explain how psychoeducation is used to treat anxity disorders

Answer 78

Person’s specific triggers, responses and impacts on their life is written down

Involves explaining to the person the idea of anxiety in general

Role of avoidance is taught (taught that anxiety can worsen with avoidance)

teach relaxation tehcniques to address fight or flight response

Question 79

Explain how cognitive techniques are used to treat anxiety disorders

Answer 79

Involves cognitive restructuring and challenging thoughts

thought diaries: to recongise automatic thoughts

Socratic questioning (am I making assumptions? COuld I misinterpret things? Am I looking at all the evidence or just what supports my thoughts? )

Question 80

Explain how behavioural techniques are used to treat anxiety disorders

Answer 80

Exposure therapy - graded exposure (very important)

Could be imaginal (making the person imagine the scenario and walking them through that experience)

In vivo (do it live)

Involves development and progression through fear hierarchy (i.e. ranking different things from 1-100, with 100 being the most scary thing, and then walking through the differnt parts of the hierarchy)

Normally coupled with relaxation techniques

These ultimately also influence cognition (exposure to feared stimuli/situation reduces judgement of probability of harm, and exposure to feared outcomes reduces judgements of cost and harm)

Question 81

Explain how biological treatments are used to treat anxiety. WHat are the issues of this?

Answer 81

Treats the symptoms and NOT the cause

Can be useful in STT

Barbituates: Quick acting - addictive, risk of OD, interacts with alc, and high relapse rate

Benzodiazepines: Quick acting - addictive, interacts with alc, high relapse rate

Antidepressants - SSRIs: Slower effects - fewer side effects, however relapse is still common

Ultimately the gold standard would be CBT + medication to treat an issue

Question 82

What are mood disorders characterised by

Answer 82

These are characterised by a disturbance in mood

They are episodic.

Question 83

What are mood disorders

Answer 83

Mood disorders are a category of mental health conditions characterized by significant disturbances in a person’s emotional state or mood, which can severely impact their daily functioning and quality of life. Mood disorders primarily involve prolonged periods of extreme sadness, elevated mood, or a combination of both. The most common mood disorders include major depressive disorder, bipolar disorder, dysthymia (persistent depressive disorder), and cyclothymic disorder.

Question 84

What is the difference between a unipolar and bipolar mood disorder

Answer 84

Unipolar is where the patient only experiences a certain extreme of a type of mood (i.e. only depressive)

Bipolar is where the patient experiences the two extremes of mood –> i.e. being both manic and depressive

Question 85

What are the key differences between DSM 4 and DSM 5 mood disorders classification

Answer 85

DSM 5 had the addition of ‘disruptive mood dysregulation disorder’ and ‘premenstrual dysphonic disorder’

In DSM 4, it categorised ‘bipolar disorders’ under mood disorders, however, in DSM 5, ‘Bipolar and related disorders’ now form a distinct category, separate from depressive disorders

DSM 5 had the new addition of persistent Depressive Disorder which combined Dysthymia and chronic major depressive disorder (?!)

Question 86

Explain sadness as a life experience

Answer 86

It is mild and temporary, and is an almost universal experience

Involves feeling blue, sad, discouraged, apathetic, lack of joy

Sadness is common after -ve experiences such as death, illness, relationship breakdown, lost/missed experiences

Feelings usually fade, and people become accustomed to the new norm

Question 87

Differentiate normal sadness from depressive disorders as a mental health condition

Answer 87

If the frequency, intensity and duration of depressive symptoms are out of proportion to person’s life situation –> depressive disorder

Responses to significant loss might include feelings of sadness, insomnia, poor appetite - resmbles depressive episode. Although these responses may be understandable or appropriate to loss, we don’t want to underdiagnose depression in people who experience loss –> clinicians use judgement based on patient history, personal and cultural context

Question 88

What is a major depressive episode

Answer 88

A major depressive episode is a period of at least two weeks during which a person experiences a pervasive and intense depressive mood or a noticeable loss of interest or pleasure in most activities. This period is marked by significant changes in emotional, cognitive, and physical functioning that differ from the person’s usual state. Major depressive episodes are central to the diagnosis of major depressive disorder (MDD) but can also occur in other conditions, such as bipolar disorder.

Question 89

What are the key symptoms of a major depressive episode

Answer 89

At least 5 or more of the following symptoms during 2 week period (need 1 and 2)

1) Depressed mood most of the day, nearly everyday

2) Markedly diminished pleasure.interest in activity

3) Significant weight loss/gain

4) Insomnia or hypersomnia nearly everyday

5) Psychomotor agitation

6) Fatigue or loss of energy nearly everyday

7) Feelings of worthlessness and excessive guilt

8) Diminished ability to concentrate

9) recurrent thoughts of death, suicide, suicide attempts

Question 90

What is a major depressive disorder

Answer 90

A diagnosed mood disorder with recurring MDEs

Single or recurrent depressive episodes? Not accounted for by other disorders?

Question 91

How is Major depressive episode different to major depressive disorder

Answer 91

Different to MDE in the idea that it is the ongoing disorder that cause episodes across individuals life. MDE just describes one episode

There could be a single or recurrent depressive episode

Question 92

Explain the prevalence and course of MDD

Answer 92

Prevalence = 5-25%

Onset is typically after puberty, peaking in 20s but could happen later on in life

Females are 2x more likely to have unipolar mood disorder vs males

Comorbidity w/ anxiety and substance taking

Course variable - remission from symtpoms, number and length of episodes

Depression has 3r highest burden of all diseases

Number one cause of non0fatal disability

Question 93

What is persistent depressive disorder

Answer 93

Depressed mood for most of the days, for at least 2 years

Question 94

Explain the symptoms of persistent depressive disorder

Answer 94

Presence of two (or more of the following)

Poor appetite or overating
Insomnia or hypersomnia
Low energy or fatigue
Low self esteem
Poor concentration or difficulty making decisions
Feelings of hopelessness

Individuals havent been without these symptoms for more than 2 months at a time

No manic or hypomanic episodes

Not better explanation by ther psychotic disorders or isn’t attributed to substane abuse or medical conditions

Question 95

Explain the prevalence and course of PDD

Answer 95

Prevalence = 1-2%

Early onset

Chronic course, might be milder than MDD but still causing distress

Lacks symptom free periods

Question 96

What are the differences between MDD and PDD (Duration, severity)

Answer 96

Duration: MDD has discrete episodes ofdepression lasting at least 2 weeks, and can experience periods of normal moods, meanwhile PDD is chronic, long term version of depression, lasting for at least 2 years with rare periods of normal mood

Severity: MDD is more severe symptoms, whereas PDD is milder but more chronic

Question 97

Outline the biological theories of depression

Answer 97

Genetic vulnerability
Neurochemistry
Neuroendocrine
Vulnerability Stress motives

Question 98

Explain genetic vulnerability as a theory of depression

Answer 98

SUggests that depression was heritable

Heritability: 35-60%. Heredity causes vulnerability to mood disorders

Question 99

Explain neurochemistry as a theory of depression

Answer 99

Low levels of nroadrenaline and/or serotonin

No good evidence for causal mechanism though

Question 100

Explain the neuroendocrine system as a theory of depression

Answer 100

Excess cortisol in response to stress

increased stress correlated to mood disorders

Question 101

Explain vulnerability stress models as a theory of depression

Answer 101

Biological vulnerability + stress –> depression

Question 102

Outline the psychological theories of depression

Answer 102

Diathesis stress models

Schema theory

Ruminative response styles

Question 103

Explain the diathesis stress model as a theory of depression

Answer 103

Cognitive vulnerability (likely from childhood –> trauma) + stress –> depression

Question 104

Explain the schema theory as a theory of depression

Answer 104

Schema = stable memory structure which guides info processing

Pre existing negative schemas could result in info processing biases (i.e. only focussing on bad things)

Question 105

Explain ruminative response styles as a theory of depression

Answer 105

Thoughts cycling over and over in our mind

Question 106

What are some biological treatments for depression

Answer 106

Drug treatments - SSRIs block reputake of serotonin, and is effective in 70-80% of the cases

Electroconvulsive therapy (ECT) - brief electrical currents to brain, and it can be effective for severe depression (80%+)

However, it is common for relapse w/ biological treatments as it is treating the symptoms, not the cause

Question 107

What is the aim of CBT in depression

Answer 107

Aim is to modify dysfunctional cognitions and related behaviours

Involves psychoeducation, behavioural activation, cognitive restructuring

Question 108

Explain the cognitive aspect of CBT in treating depression

Answer 108

Address cognitive errors

Develop realistic view

Remove lens of negative schemes

NOT positive thinking, as it doesn’t normally work - patients need to know whats going on in their mind

Question 109

Explain the behavioural aspect of CBT in treating depression

Answer 109

Behavioural experiments; testing the persons beliefs, and gathering evidence to disconfirm negative beliefs

Behavioural activation: increase reinforcing/postiive events (things to look forward to, identifying goals and values, building upward spiral of motivation + energy through mastery

Question 110

Outlne the vicious cycle of depression

Answer 110

Feel depressed –> -ve thinking about self and world –> increased lethargy –> reduction of activity and social withdrawl –> loss of pleasure and achievement –> feel depressed

cycle continues

Question 111

What are the differences between DSM4 and DSM 5 feeding and eating disorders

Answer 111

DSM 5 added the avoidant/restrictive food intake disorder, pica and rumination disorder

DSM 4 had EDNOS (eating disorder not otherwise specified) - broad category for eating dosorders that didn’t meet full criteria for anorexia or bulimia nervosa. DSM 5 replaced EDNOS w/ two more specific categories (other specific feeding or eating disorder, unspecified feeding or eating disorder)

Binge eating disorder became an official, distinct eating disorder in DSM 5, whereas DSM 4 it was in EDNOS

Question 112

What are the key/diagnostic features of anorexia nervosa (AN)

Answer 112

Restriction of energy intake –> significantly low body weight in context of age, sex, developmental trajectory and physical health

Intense fear of gaining weight or of becoming fat, or persistent behaviour that interferes w/ weight gain, even at a low weight

Disturbance in way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self evaluation, or persistent lack of recognition of seriousness of current low body weight

Question 113

What is the severity of AN

Answer 113

Level of severeity depends on the BMI

Mild (BMI 17-18)
Moderate (BMI 16-17)
Severe (BMI 15-16)
Extreme (BMI <15)

Level of severeity may be increased to reflect clinical symptoms, the degrees of functional disability and need for supervision to eat

Question 114

WHat are the subtypes of AN

Answer 114

Restricting and binge-eating/purging type

Question 115

Explain AN restricting type

Answer 115

During last 3 months, individuals has not engaged in recurrent episodes of binge eating or purging –> if not it is a different diagnosis

It is the presentations in which weight loss is accomplished primarily through dieting, fasting and/or excessive exercise

Question 116

Explain AN binge-eating/purging type

Answer 116

During last 3 months, individual has engaged in recurrent episodes of binge eating or purging behaviours (i.e. self induced vomiting or misuse of laxatives, diuretics or enemas)

Question 117

What are the associated psychological problems with AN

Answer 117

Depressed mood, irritability, anger, social withdrawl, preoccupation w/ food, poor concentration

Often associated with ‘starvation syndrome’ –> tough emotional experiences

Comorbid: Mood disorder, anxiety disorder, substance use disorder, personality disorder

Question 118

What are the associated physical problems with AN

Answer 118

Low body temp, brittle hairs/nails, hair growth

Osteoporosis (brittle bones)

Metabolic disturbances, heart failure

Malnutrition, anemia, immune system suppression

Mortality rate = 5-10% over 10 year period (cardiovascular complications, suicide)

Question 119

What is the prevalence of AN

Answer 119

Affects 0.5-1.0% of females

90% of individuals w/ AN are female

Rates are increasing in Aus

Age of onset is typically mid-late adolescence - appears to be getting younger

Question 120

What is the course of AN

Answer 120

Chronic, slow recovery (up to 10 years)

Treatment seeking challenges

20% remain chronically ill

Recovery depends on the definition (right BMI? right thinking?)

About 56% go on to develop Bulimia nervosa

It also has the highest mortality rate of all psychiatric diseases

Question 121

What are the key/diagnostic features of bulimia nervosa (BN)

Answer 121

Recurrent episodes of binge eating, characterised by:

Eating in a discrete period of time an amount of food that is definitely larger than what most people would eat during a similar period of time and circumstances

Sense of a lack of control over eating during the episode

Recurrent inappropriate compensatory behaviours in order to avoid weight gain –> laxative abuse, excessive exercise, fasting

Has to occur at least once a week for 3 months

Self evaluation unduly influenced by body shape

Question 122

What are the associated psychological problems with BN

Answer 122

Comorbid mood disorders, anxiety disorders, substance abuse, personality disorders (bipolar)

Question 123

What are the associated physical problems with BN

Answer 123

Associated with binges (e.g. stomach problems)

Most physical problems are associated w/ compensatory behaviours (I.e. vomiting: stomach acid –> loss of dental enamel, scarring, ulceration of oesophagus, laxatives: loss of normal bowel function, dehydration, electrolyte imbalance)

Question 124

What was the prevalence of BN

Answer 124

Affects 1-3% of females; becoming more recognised in males

90% of individuals w/ BN are female

Males - purging is less frequent, instead they normally undertake exercise as compensatory behaviours

Question 125

What was the course of BN

Answer 125

LT outcome is better than for AN

10% still affected after 10 years

Question 126

What were the key/diagnostic features of binge eating disorder (BED)

Answer 126

Recurrent episodes of binge eating (eating in a period of time, an amoun of food that is larger than what most people would eat in a similar period and circumstance)

Marked distress regarding binge eating is present

Binge eating at least once a week for 3 months

No association w/ BN or AN

Lack of control over eating during the episode. ALso includes association w/ 3 or more of the following:

Eating much more rapidly than normal

Eating until feeling uncomfortably full

Eating large amounts of food when not feeling physically hungry

Eating alone bc of embarrassment of how much they are eating

Feeling discussed with oneself, depressed or guilty afterwards

Question 127

What is the difference between BED and BN

Answer 127

BN has active actions to try compensate for their excesive eating, wheras BED is not

Question 128

What was the prevalence of BED

Answer 128

Affects 2.5% of population (2:1 female/male ratio)

Onset is adolescence to early adulthood

Question 129

Explain the course of BED

Answer 129

Remission rates higher for BED than AN/BN

Associated w/ higher rates of obesity –> more blood pressure, more cholestrol, type 2 diabetes and heart disease

Question 130

Explain the biological theories of causation in eating disorders

Answer 130

Genetic factors; moderate heritability of AN and BN, increased depression, personality disorders and substance use in families of people w/ eating disorders

Neurotransmitter disturbances; serotonin involved in appetite regulation –> mixed findings regarding direction of causation

Question 131

Explain the psychological theories of causation in eating disorders

Answer 131

AN and BN have many features in common:

Tendency to base self worth on weight/shape

Intense fear of gaining weight

Desire to attain unrealistic levels of thinnness

Transdiagnostic model

Question 132

Explain the transdiagnostic model

Answer 132

Core low self esteem, distress tolerance, interpersonal difficulties, perfectionism

Question 133

Explain the pscyhosocial theories of causation in eating disorders

Answer 133

Family factors: High parental or sibling criticism, control and conflict, comments on eating behaviours, low parental empathy

Peer factors: Peer group w/ eating disorders, social approbal

Sociocultural factors: Cultural emphasis on thinness which emerged in the late 20th century

Ultimately, the idealisation of thinness is seen as a contributing factor to normative body dissatisfaction that females experience in western cultures.

Eating disorders are prevalent in subcultures where thin ideal is amplified

Question 134

Explain the biological treatment of eating disorders

Answer 134

Medical management (i.e. medicines)

“Re feeding”

Dietician

Inpatient/outpatient depending on severeity

Question 135

Explain the psychological treatment of eating disorders for adults

Answer 135

Stage 1 (Starting well) - personalised formulation, psychoeducation, behavioural focus (self monitor and regularly eat)

Stage 2 (Taking stock) - Joint review of progress, identify problems to address and barriers to change

Stage 3 (Addressing maintaining factors) - Main body of treatment, involves addressing key maintaining factors (weight/shape, mood related eating behaviours)

Stage 4 (ending well) - Ensuring progress is maintained, relapse prevention

Question 136

Explain the psychological treatment of eating disorders for children/adolescents

Answer 136

Key emphasis on parental involvement/responsibility in home setting

2/3 are fully weight restoed, and 75-90% restored at 5 year followups

Phase 1: Parents in charge of weight restoration - “re feeding”

Phase 2: Parents transition control over eating back to adolescent (very therapeutic)

Phase 3: Discuss adolescent developmental issue, establish health identity

Question 137

Path to become psychiatrist

Answer 137

Fully-qualified medical doctor

Specialist training and qualifications in the diagnosis, treatment and prevention of mental illness

Specialised knowledge of neurobiological changes/causes of mental disorders

In general, treat people with a diagnosed mental disorder

Can prescribe medication for mental health conditions

Treatment takes a bio -medical approach (some also take a psychological approach)

• Medical degree
• 4-6 years (depending on whether you are
  coming into the degree as a university
  undergraduate or graduate
• Internship
• 1 year of hospital rotations/placement
• Residency
• 1 year of specialised hospital
  rotations/placements
• Vocational Training
• 5 years to complete a Fellowship of the Royal
  Australian and New Zealand College of
  Psychiatrists (FRANZCP)

Question 138

Path to become clinical psycholgist

Answer 138

Look at book - should be common sense

Question 139

What do social workers do? What are the qualifications and training involved

Answer 139

1. Work in direct services (e.g., healthcare, welfare, housing etc.)
   * Helping people cope with problems related to social cultural issues including
   but not limited to poverty, legal issues or human rights
2. Work in the clinical field (more similar to psychologists)
   * Diagnose and treat mental, behavioural or emotional health issues
   * Focus: environment and cultural factors (sociological approach) rather than
   psychological or personal characteristics (i.e. Family Therapy)
   * Help clients develop practical plans to improve personal well well-being and make
   referrals for services

Qualifications & Training

Bachelor of Social work (4 years)

Masters of Social Work (2 years + other 3 year Bachelor degree)

Question 140

What do counsellors do? What are the qualifications and training involved

Answer 140

Assist people to gain understanding of themselves and make changes in
their lives:

May simply provide a non-judgmental ‘listening ear’
May work in a particular area (e.g. marriage/family/school counsellors)

Qualifications & Training:
Level of training is wide and varied
Ranging from weekend correspondence course to Bachelor degree
The term ‘counsellor’ can be used without any particular qualification

To register as fully qualified:
Bachelor of Counselling (3 years)
Graduate Diploma in Counselling (2 years) + previous Bachelor degree

Question 141

What are the restricted titles

Answer 141

Psychologist is a restricted title. Can only use this if you are registered with the psychology board register

Question 142

What are some unrestricted titles

Answer 142

Counsellor, Therapist, Psychotherapist, Life
Coach, Spiritual Advisor