Mental illnesses Flashcards
Define mental health
Capacity of an individual to behave in a way that promotes the emotional and social well-being
Define mental health problems
Wide range of emotional and behavioural abnormalities that affect people throughout their lives
Define mental disorder
A clinically recognisable set of symptoms and behaviours that cause distress to the individual and impair their ability to function as usual
What is the biopsychosocial model?
Mental health and related disorders are influenced by a number of factors it interlink
Biological factors include genetics, hormones, and neurotransmitters imbalances
Psychological factors include cognitive biases, coping skills and thought patterns
Social factors include social support, experience, trauma or stress
What is the diathesis-stress model?
Diathesis: individuals possess internal factors which predisposes them
Stress: an environmental cue which triggers the mental illness
The greater the diathesis, the less stressors needed to trigger
What does statistical infrequency mean in relation to abnormality?
Limitations?
Behaviour or disorder is statistically rare in the population
However not all rare behaviours are psychological disorders and not all psychological disorders are rare
Explain personal distress in relation to abnormality
Limitations?
The person is experiencing relatively high levels of personal stress
not all distressed people are demonstrating abnormal behaviour such as grieving
Explain impairment in relation to abnormality
Limitations?
There is a reduced capacity to perform typical every day functions this can be evidenced by relationships social and occupational dysfunction
however other non-psychological disorders and personality traits such as laziness can cause impairment
Explain violation of norms in relation to abnormality
Limitations?
The person is displaying behaviours that aren’t socially appropriate
not all socially inappropriate behaviour is reflective of mental illness for example homosexuality was once considered a disorder
Explain biological dysfunction in relation to abnormality
Limitations?
There is a neurological impairment with empirical evidence supporting
some psychological disorders are learnt such as phobias
What are some diagnostic issues when it comes to mental illnesses?
Social context: Labelling behaviour is psychopathological when is socially inconvenient
Labelling vs diagnosing: creation of terms allegedly describing a disorder that has no evidence or support. Eg shopping compulsive disorder
Cultural differences: some disorders are specific to certain cultures however most are universal
What are some strengths of the DSM?
Atheoretical
provides strict criteria biopsychosocial approach
allows international consensus
What are some weaknesses of the DSM?
Validity of some disorders are questionable
comorbidity:is a really one underlying disorder?
categorical versus dimensional model
Explain panic disorder
Characterised by sudden and repeated feelings of terror and anxiety are high anxiety episodes that peak within 10 minutes
Includes four of the following:
Racing heart rate, difficulty breathing, chest pain, chest discomfort, hot or cold flushes, choking sensation, dizziness, fear of imminent death, numbness or tingling sensation, depersonalisation, nausea, abdominal discomfort, sweating, trembling, fear or loss of control or going insane
How common is panic disorder in men and women?
Men 2%
women 5%
Explain generalised anxiety disorder
Chronic excessive anxiety that occurs for at least six months
Can be characterised by at least three of the following:
Restlessness, feeling on edge, being easily fatigued, difficulty concentrating, mind going blank, irritability, muscle tension & sleep disturbance
How prevalent is generalised anxiety disorder in men and women?
Men 2% women 3.5%
Explain a phobia
Chronic excessive fear that is cues by the presence of a specific object or situation
immediate anxiety which takes the form of a panic attack
Explain social phobia
fear of one or more social performance situations in which the person is exposed to unfamiliar people or to possible scrutiny
What is agoraphobia?
Fear of being in places or situations from which escape may be difficult
What is the criteria for post-traumatic stress disorder
- exposure to a traumatic event which resulted in a response of intense fear helplessness or horror
- Persistent re-experiencing of the traumatic event
- Persistent avoidance of the stimuli associated with the traumatic event and a numbing of general responsiveness
- Persistent symptoms of general arousal
How long after the trauma will PTSD occur
Normally within three months
What is the prevalence of PTSD
General population 1 to 14%
high at risk groups are 3 to 58%
Explain OCD
Mind is flooded with persistent and uncontrollable thoughts and the individual is compelled to repeat certain acts causing distress and interference with everyday functioning
How prevalent is OCD
2 to 3% of the population and is more common in women
What are the three Cs of OCD
Cleaning counting checking
What is a depressive disorder
Characterised by disturbances to mood and emotion
Explain major depressive disorder
Requires the presence of depressive symptoms for at least two weeks
How prevalent is major depressive disorder
Women 10 to 25% and men 5 to 12%
What are the theories of cause of depression
Life events/environmental factors interpersonal model behavioural model cognitive model (Beck) learned helplessness (Seligman) biological causes
What is the interpersonal model?
Behaviours associated with depression lead to increased social isolation and increased depression.
Depressed mood ➡️ excessive support seeking ➡️ increased pressure on relationships ➡️ avoidance/frustration in others
Symptoms of depression?
- sad, depressed mood most of the day, everyday
- loss of interest in usual activities
- difficulty sleeping
- shift in activity level
- poor appetite and weight loss
- increased appetite and weight gain
- loss of energy
- fatigue
- negative self concept and feelings of worthlessness, self blame etc
- difficulty concentrating
- recurrent thoughts of death or suicide
What is the behavioural model of depression?
Lack of reinforcement when engaging in social or pleasurable activities leads to withdrawal this reduces the likelihood of reward even more they maybe positively reinforce for withdrawing such as others showing increased concern and empathy
therefore this model suggests that depression can be reduced simply by reingaging in social or pleasant activities although this may require considerable effort
What is the cognitive model of depression (Becks theory of depression)
Have a negative triad of world, self and future and therefore believes negative thoughts you begin to see things through a bias which leads to depression
Explain learned helplessness
Is a behaviour exhibited by a subject after enduring repeated aversive stimuli beyond their control
There is a bad aversive event that you can’t change which therefore leads to depression and then you believe you can’t do anything about the depression
What are the biological causes of depression
Twin studies indicate a medium effect of genes - people who have two copies of a stress sensitive gene are more vulnerable to developing depression following a stressful event
What is bipolar disorder
Characterised by the presence of a manic episode and an episode of depression
How many people that have a bipolar episode have a second one
90% have a second episode
Is bipolar reoccurring
Yes
Are those with bipolar more likely to commit suicide
If yes, by how much
Those with bipolar are 15 times more likely to commit suicide than the general population
What does bipolar involve
An extreme increase in activity level, talkativeness, rapid speech, less than the usual amount of sleep is needed, distractibility & excessive involvement in pleasure activities that are more likely to have undesirable consequences
When does schizophrenia typically begin
Early adult hood in males typically 18 years old in females 25 years old
Do genetics influence the onset of schizophrenia
The risk of developing schizophrenia is a function of how closely an individual is genetically related to a person that has schizophrenia
Monozygotic twins and someone with two parents affected are at the greatest risk
How does the diathesis-stress model affect schizophrenia
People with an underlying vulnerability such as a genetic predisposition may develop it by experiencing additional stresses
What are the different types of hallucinations
Auditory: voices commenting or conversing
Somatic/tactile: (touch) feels as though someone is touching you
Olfactory: smelling things
Visual: seeing things
What are delusions
Strange beliefs that are maintained despite evidence they may be well formed or they may be weekly held
What is thought disorder
Tendency of thought to move along associative lines rather than being controlled logical or purposeful
What is derailment
Ideas slip off track to related ideas
What is circumstantiality
Stays on track but very delayed in reaching the end goal
What is distractible speech
Speech will change mid sentence in response to a distraction or stimuli
What is clang associations
Sounds govern word choice rather than meaning
Explain negative symptoms
A lack of something that the individual would normally have
Disappearance of abilities emotions or drives that are usually present
What is blunting
Unchanging expression
What is Alogia
Poverty of speech, increased latency of response
What is avolition
Poor hygiene and low motivation
What is anhedonia?
Loss of enjoyment or interest
What are personality disorders
Disorder variations in personality
How are personality disorders grouped
Into clusters
What is cluster (A) of personality disorders
Odd and eccentric
Is the most common cluster (A) personality disorder
Paranoid personality disorder
What is paranoid personality disorder
A pervasive distrust and suspiciousness of others.
Assuming that others intentions are malevolent
What are the symptoms of paranoid personality disorder
Preoccupied with doubts about loyalty or an trustworthiness of friends and family
Unwilling to confide in others
constantly bearing grudges
compliments are misinterpreted as criticism
jokes don’t go down
well reluctant to provide personal information
pathologically jealous
There any sex differences in paranoid personality disorder
There are no sex differences
Is the prevalence of paranoid personality disorder
0.5-2.5%
What are cluster (B) personality disorders
Dramatic emotional erratic
What is the most common cluster (B)personality disorder
Borderline personality disorder
What is borderline personality disorder
Long-term instability of relationships, self image and mood
How prevalent is borderline personality disorder
2% of the general population and mainly females
Is borderline personality disorder comorbid with anything
Mood and substance disorders
What does borderline personality disorder include
Trying hard to avoid abandonment, unstable intense relationships, often swinging between idolising and devaluing the other person, unstable sense of self, chronic feelings of emptiness, short-term paranoid thoughts and anger problems
What is antisocial personality disorder
Comes under cluster B
Is a long-term disregard for and a violation of the rights of others
What does antisocial personality disorder include
A failure to conform to social norms, repeated lying, irritability, aggressiveness, disregard for safety, lack of remorse
How prevalent is antisocial personality disorder
.2 to 3.3% of the population and is most common in males
What are cluster (C) personality disorders
Anxious and fearful
What is an example of a cluster (C) disorder
Dependent personality disorder
What is dependent personality disorder
A constant and extreme need to be taken care of that leads to submissive clingy behaviour and A fear of separation
What does dependent personality disorder include
Difficulty making everyday decisions without others, fears disagreeing with others even when chance of anger is minimal, lack of confidence to initiate activity, takes extreme steps to get support from others, frantically seeking new relationships
How prevalent is dependent personality disorder
0.4-0.6% of the population
Is dependent personality disorder more prevalent in women or men
Females
What is the most frequently reported personality disorder
Dependent personality disorder
What is derealisation
The feelings of your surroundings are not real well that familiar places are new or unknown
What is depersonalisation
The feeling you are not real living in a dream or watching yourself from the outside
What do dissociative disorders disrupt
Consciousness memory identity perception
What are the two types of Dissociatives disorder
Derealisation and depersonalisation
What are the symptoms of depersonalisation disorder?
- May feel robotic or as if lacking control
- May feel detached from self, emotions, thoughts or specific parts of the body
- to be diagnosed, the person must be experiencing clinically significant distress or impairment in daily functioning
What is dissociative amnesia?
The forgetting of personal information, particularly surrounding a stressful event
Criticisms of dissociative amnesia?
We normally have gaps in memory, intentional forgetting vs amnesia
What is dissociative fugue?
Combination of forgetting personal life and actively removing oneself from setting
Eg. Moving to a new town
What is dissociative identity disorder (DID)?
Experiencing two or more discrete identity/personality states, which alternative in control of behaviour
What are the explanations for DID?
Post traumatic model:
Early trauma abuse has lead the person to develop multiple personalities to cope with stress
Sociocognitive model: questions the validity of having numerous personalities. Therapy often reinforces the idea that there are multiple personalities
What are neurodevelopmental disorders?
A class of disorders that commence during childhood or prenatal development
What does autism spectrum disorder include?
Deficits in social communication and interaction:
Can’t engage in social emotional reciprocity, difficultly expressing and interpreting non-verbal behaviour, difficulty forming and understanding relationships
Restricted, repetitive behaviours, interests or activities:
Repetitive motor movements, insistence of sameness, inflexibility and ritualised behaviour
Narrow fixated interests
What is the prevalence of Autism?
0.6-2%
Is autism for common in males or females?
Males x4
Is autism genetic?
Yes. It has a strong genetic component
What is ADHD?
Attention deficit hyperactivity disorder.
Characterised by inattention, impulsivity and hyperactivity that impacts daily functioning
What are some components of inattention (ADHD)?
Can’t pay close attention Doesn’t listen Fails to complete tasks Can’t organise tasks and activities Reluctant to engage in effortful mental tasks Loses materials required for tasks Easily distracted Forgetful in daily activities
What are some components of hyperactivity (ADHD)?
Restless Leaves seat in situations required to stay seated Runs or climbs in inappropriate situations Unable to play in a quiet manner Often on the go Blurts answers or interrupts Difficulty waiting their turn Interiors or intrudes on others
What is the prevalence of ADHD?
2.3-6% of school aged people
Is ADHD more common in males or females?
5-9x more common in males
Is ADHD genetic?
Yes. Appears to run in families
What are neurocognitive disorders?
A class of disorders where the main symptom is cognitive impairments
What is dementia?
Umbrella term for a range of disorders where there is a steady decline in cognition that is irreversible.
What is Alzheimer’s?
Type of dementia.
Degenerative brain disorder that involves progressive cognitive disorder.
What is the most common form of dementia?
Alzheimer’s
How do you determine if someone has Alzheimer’s?
Can only be determined post-mortem as have to cut brain open to see
So how do they diagnose Alzheimer’s if can only be determined after death?
Categorised into:
Probable Alzheimer’s disease
Possible Alzheimer’s disease
What is probable Alzheimer’s disease?
If there is a family history and/or there is significant cognitive decline
What is possible Alzheimer’s disease?
If there is no family history but there is a steady decline that can’t be explained by other medical history
What is the average lifespan after diagnosis of Alzheimer’s?
10 years
How prevalent is Alzheimer’s in 65+ y/os
13%
How prevalent is Alzheimer’s in 85+ y/os
42%
Is there any differences in prevalence between genders (Alzheimer’s)?
Tends to be more frequent in females
What happens to the brain during Alzheimer’s?
Neurofibrillary tangles
Senile plaques
Neuron loss (in specific regions)
What are neurofibrillary tangles?
Threads of protein that occur within a neuron
What are senile plaques?
Deposits cased by debris from degenerating neurons and build up of protein
Does Alzheimer’s have any impact on mood?
Depression, argumentative, restlessness, motor impairments, motor agitation and psychosis
What are some causes of Alzheimer’s?
Genetic factors: there is strong evidence that a number of genes influence likeliness
Medical history: previous experience of a traumatic brain injury reduces the risk of developing
What is the formula for BMI?
BMI = weight(kg)/height(m2)
What is anorexia nervosa?
Intense fear of gaining weight and becoming fat - they have a distorted body image.
They are severely underweight with a BMI under 18.5
What are the two types of anorexia nervosa?
Restricting type: weight loss accomplished primarily through dieting, fasting or excessive exercise
Binge eating/purging type: last 3 months, the individual has engaged in recurrent episodes of binge eating, or purging behaviour such as self induced vomiting or the misuse of laxatives
What is the prevalence of anorexia nervosa?
Less than 1% in the general population
Is anorexia comorbid with anything?
Anxiety, mood and personality disorders.
Also higher suicide
What are the physical consequences of anorexia?
Low blood pressure Heart/kidney/gastrointestinal problems None mass density declines Dry skin Brittle nails Anaemia Hormone changes Hair loss Hair growth Electrolyte changes Amenorrhea
What is bulimia?
frequent episodes of bing eating - seem out of their control
compensation for this includes vomiting, fasting or exercise
are people with bulimia underweight?
No - they tend to be in a normal weight range or slightly overweight
Are people with bulimia more likely to commit suicide?
Yes - their likeliness is 4% higher
How many episodes are in mild bulimia?
1-3 per week
How many episodes are in moderate bulimia?
4-7 per week
How many episodes are in severe bulimia?
8-13 per week
How many episodes are in extreme bulimia?
14+
what is the prevalence of bulimia?
0.5% in males and 1.5% in females
Is there anywhere that bulimia is less common?
less frequent in non westernised countries
Demonic model?
Belief that mental illness was due to demonic possession it was prevalent in the middle ages but still exists
What is the medical model?
Mental illness seen as a physical ailment it could be cured
Lead to hospitalisation of individuals in asylums
What is institutionalisation?
Poor treatment efficacy and conditions in asylums
What is deinstitutionalisation?
Lead to more effective treatment and allowed a more normal life for those with mental illnesses but also lead to high levels of homelessness and poverty
What are the theories of anxiety?
Learning processes
- classical conditioning
- operant conditioning
- modelling: observing someone else be afraid of something
What is dysthymia disorder?
Less severe but more chronic form of depression requires the presence of a depressed mood for a period of at least two years
How prevalent is dysthymia?
6 to8% in women and 5% in men
Is suicide classified as a disorder
No it is not in the DSM as a disorder but it accounts for 1.4% of deaths in Australia
What are some myths about suicide
Talking to depressed people about suicide makes them more likely to
Suicide threats are attention seeking
People that talk about suicide almost never commit it
Which drug reduces dopamine?
Chlorpromazine
Can chlorpromazine be used to treat schizophrenia?
It reduced positive symptoms but negative symptoms were made worse
How should we observe personality disorders?
Needs to be longitudinally
Does ADHD persist into adulthood?
Yes. Hyperactivity symptoms decline and inattention remains
How is memory lost with Alzheimer’s?
Recent memories are the first to be lost and then progresses chronologically backwards
What BMI correlates with mild anorexia?
Greater than 17
Which BMI scores indicate moderate severity of anorexia?
16-16.99
What BMI score indicates severe anorexia?
15-15.99
What BMI score correlates with extreme anorexia?
Less than 15
When in anorexia typically onset?
Early to middle adolescence. Rarely before puberty or after the age of 50.
Commonly associated with a history of dieting
What can binges be triggered by?
Stress or negative emotions
What are the physical consequences of bulimia?
Amenorrhea
Electrolyte imbalances
Dental problems
Swollen salivary glands
What are the theories of schizophrenia?
Dopamine hypothesis: chlorpromazine a drug that reduces dopamine reduced positive symptoms of schizophrenia
Diathesis-stress model: underlying biological vulnerability may develop schizophrenia as a result of a stressor
What is schizophrenia?
Umbrella term for a number of disorders that involve a loss of contact with reality typically including delusions and hallucinations.
Disruptions in normal mental functions such as thoughts feelings and behaviour
Persecutory delusions?
People think they are or will be persecuted
Grandiose delusions?
Inflated sense of worth, power, knowledge, or identity
Religious delusions?
Preoccupied with religious subjects that are not within the expected beliefs for an individual’s background
Somatic delusions?
bodily functioning, bodily sensations or physical appearance. Usually the false belief is that the body is somehow diseased, abnormal or changed.
Delusions of reference?
Ideas of reference and delusions of reference describe the phenomenon of an individual experiencing innocuous events or mere coincidences and believing they have strong personal significance.
