PSYCHOPATHOLOGY Flashcards
are children or adults more likely to have psychopathology
children
hauora - te whare tapa wha
a maori lens of health that explores various aspects of wellbeing, that allows pathopsychology to prioritise maori and their wellbeing
4 walls
1. taha hinengaro - emotional
2. taha tinana - physical
3. taha wairu - spiritual
4. taha whanau - social
are treatments of psychopathology always effective
only in some settings
% of people in NZ that meet the media for a mental disorder and those that was in the last 6 months
40%
60%
Te Rau Hinengaro: The NZ mental health survey
aim - understand the prevalence of mental health disorders, barriers of its healthcare use and in it many cultures
findings - around 13000 people 16+ were interviewed, maori+pacific people were over-sampled, and the three most common disorders were
- anxiety
- mood
- substance use
maori and pacific are less likely to have access to treatment services
what is psychopathology
refers to the study of psychological disorders
what are the fives things that help define disorders
- infrequency
- deviance
- distress
- disability
- danger
infrequency
how often it occurs
deviance
behaviours that are not considered typical
- these often differ between cultures
distress
- the suffering experience
- it can be experienced by self and/or others
disability
the degrees of the impairment experienced
- this differs by individual
danger
degree of risk
- to self
- to others
- from others
- to property
how do we classify disorders and what it gives us
book called DSM-5-TR that is regularly updates
gives us -
a common language
supports evidence
keeps up to date as research grows
Anxiety
- one of the most common disorders
- future focused and is an anticipated threat
not infrequent
but associates with distress, disability, danger
- thoughts, worries, avoidance, sweating
Fear or Panic
- present focused
- immediate threat
- autonomic
Te Rau Hinengaro
25-29% of adults will meet the criteria for one disorder at some point in their life
who can receive therapy
- individuals
- couples
- family
- groups
- communities
Give people, skills and knowledge, so that they no longer need help as they know what skills they need to undergo
biomedical vs psychological approach
Psychologists vs therapists
disease vs thought and behaviour
changing physical functioning vs changing how we things, feel and our behaviours
medication and surgery vs therapy
psychodynamic approach
not the most common anymore, but parts of it are
aim: for clients to achieve insight and how these affect their process, strong focus on the past
behavioural approach
clients to identify the behaviours that the cause of their disorder
- a focus on reinforcement rather than a punishment
- exposure therapy
cognitive approach
idea that clients and address maladaptive thoughts, beliefs and assumptions made (negative beliefs about ourselves)
eg. do people really hate you or not really
third way cognitive therapy
mindfulness (having a thought then letting it go)
which treatment is the best
combined treatment
which is common treatment for anxiety and depression
CBT
personality disorders
persistent set of behaviours across multiple setting
- sort of a view you have through life in every setting eg. you may see the world as scary in every settings
early experiences change the way you think about the world, which makes this stable over time
develops in childhood from experiences so its not actually there fault
- difficult in social interactions
- intense or reduced reactions
- inflexible thinking patterns
three clusters of personality disorders
cluster A B C
A - odd or eccentric
B - Dramatic
C - Anxious
is you have a disorder you have a ___% chance of having another one
50%
there are around 10 criteria per disorder but
you only need to have a few to have the disorder, so different people act different with the personaility
causes of personality disorders
- little genetics
- childhood experiences
- individual temperament (right up bringing for that child)
treatment for personality disorders
if on the boarder
otherwise no but have evidence based protocols (eg therapy)
difficulties or treating personality disorders
- takes longer
- therapy is difficult
- poor research base
- high levels of stigma
psychosis
- focus on your perception of reality
- difficulties in distinguishing what is real and what is not
- high levels of distress
- mainly is young adults as this is when most do experience with drugs
- relatively common
- can be caused by psych disorders, major stress, drug use
schizophrenia
you need 2 or more of
- delusions
- hallucinations
- disorganised speech
- catatonia (won’t interact, they just sit there
- negative symtoms
causes of schizophrenia
- brain disorders
- brith month
- pregnancy or birth complications
schizophrenia treatment
- anti-psychotic
- CBT
clusters of symptoms
postive/negative/disorganised symptoms
psychosis care in NZ
early interventions teams
- wrap around (work as a team)
- 3 years of care
there are barriers preventing people from care
bipolar 1 VS bipolar 2
bipolar one is when they have extreme periods of an elevated mood (manic) , and then depression and normal mood at some points
bipolar 2 is people that have an increase elevation mood but not to the same level (hypomanic) as bipolar 1
bipolar disorder
bipolar one and two
rapid cycling associated with the worse outcomes - the amount of time between each episode (being manic, normal or depressed) is short
major depressive disorder - MMD
this is when you don’t have the high manic/normal episodes
they must have one of low mood, loss of interests, loss of pleasure
it can look different for every person for example then they often, lose/gain weight, sleep lots or not at all, thoughts of self harm etc
MMD causes
combination of factors
- genetics
- environment (social or psych)
cognitive theories + beck’s theory
how our thoughts and feelings and physical behaviours interacts with one another
beck’s theory that these feelings are about
our negative through and beliefs are normally about often about so if we stop these depression will decrease
- self
- world
- future
cognitive disorders
many different ones
when people grab onto an same idea and then make it a big issue
cognitive therapy
focusing and addressing thought
- automatic
- addressing attitudes, thinking styles
- changing schemas
has good evidence
CBT and culture
therapy technique that Benett used for CBT depression
- focuses on individual needs, so if value community you may struggle to put yourself first
- so adapted this theory to work for maori and pacific to help to focus on
- world view
- around family
- self - disclosure
- fostering therapeutic relationship (therapist sharing things which normally you don’t do)
- metaphors using them to to see things
type of cognitive therapy - commitment and acceptance therapy
noticing thoughts that come in and not attaching to them
with the thoughts you think if it aligns with your values
antidepressants
some people like them some don’t
- some evidence shows that it is good
- but can have some side effects
go over what each delusion is - summary of them at the start of lecture 33
intrusive thoughts
- very common, yet they have distressing content
- in terms of OCD they thoughts are accompanied by compulsions
Te Pa Harakeke
flax model
shows child sprouting from the top and then parents and grandparents who protect the new part of the plant and then the child will be protected so that the plant can survive and then then as they go into the ground they then provide the nutrients
neurodevelopment disorders
are present during childhood, so can be normal then
- can be diagnosed/issue in adulthood too
key features
- during developmental period
- genetic/biological cause
- occur across a lifespan
eg.
- intellectual disability
learning disorders
ADHD
behavioural disruptive disorders
- oppositional defiant disorder is when the children don’t obey to any authority above them
- conduct disorder - do abnormal things
- tends to be externalising disorders where you can see the behaviour of the child so environmental factors are important
maladaptive coping strategies
that young kids will engage in
- risk of comorbidities
- difficulty with substances
- danger to physical-health
- disability
risk of comorbidities
when a child has a disorder that isn’t being supported which can lead to them having more disorders
black and white thinking - depression
this is when you think something is either black or white nothing in between
eg. you are either a bad sister or a good sister no in-between
catastrophising - depression
when you think you are in the worse situation and exaggerate the situation you are in - this is when you take a small thought and make it into a big negative deal
treatment to behavioural disruptive disorders
- psycho-education
- developing skills with the whole family/school
- supportive services
- medication
child adaptions to CBT
- standing off skateboard
get the children to say why they feel off, and what they are thinking and then what is happening at home which are the footpath - in waka with others rowing, and what will happen if someone doesn’t paddle etc
NZ CBT access and why and %
- is hard to access in NZ
1/3 of children have been referred to services
50% of parents report barriers due to cost and waitlist
why might young people use substances
- anxiety and depression
- stress
- developmentally normal
substance use criteria - many adults (5)
- tolerance (get used to the drunk)
- withdrawal
- people spend a lot of time obtaining and using substances
- degree of distress
- costs of physical activity and wellbeing
substance use criteria - adolescents
- issues with binge drinking
- relationships to so-morbidities (manage anxiety of stress for example
substance use NZ study
- alcohol is most common substance
- overall their is a decrease in substance use
- but some are rising
narrative review
combined findings across many studies and aims to show trends along time
adults have different or same as children substance abuse and why
differ
- many significant life changes
- development
- and increase in pathopsychology in general
substance abuse treatment
- medication
- programmes like AA
- CBT
- motivational interviewing
motivational interviewing
this is when they help people to make a change
- impairments to wellbeing
- aspects of hauora
anti-social personality disorder
- should change as one gets older
the role of family and substances
- young people need support to make change
- and support in general
tinana
is the fact that your psychological health can impact your physical heath and vice versa
insomnia
is when you have dissatisfaction with sleep for at least 3 months, either quantity or quality
across 1 or more of
- falling, maintain sleep or early mornings awaken
= distress
NZ sleep issue are…
high, have lots of bad sleep, which can then lead to poorer physical health
causes of insomnia
physical
- sleep obstruction (snoring blocking airway and lack air so wake up)
- pain
psych
- stress
- poor sleep hygiene
treatment of insomnia
- identifying the causes
- medical, environmental or psychological intervention
sleep hygiene
- habits eg. napping
- environment
- getting ready for bed
stress
our body’s response to demand or threat in our environment
both short and long term
short term stress
inverse U theory - need to have optimal arousal to reach your optimal performance
low arousal (stress) aren’t motivated have no interest = low performance
high arousal is to much anxiety = lower performance
long term stress
- affects our physical system = increased hormones and ageing
- affects our mental health
stress treatment
- life styles changes
- focus on values
- relaxation and mindfulness
- skills training
- setting boundaries
- problem solving
stress treatments are effective but
systemic factors affect access to treatment
- risk factors
- historical factors
- current processes eg. racism
in terms of stress treatment what can we do from maori
maori and then pacific beliefs in term of therapy
eating disorders NZ stats
- 1.7% lifetime prevalence
- more common in females
- across all ethnicities
- around 17 years of age
binge eating disorder criteria
A recurrent episodes of binge eating
B - and then 3 + of
- eating more rapidly than normal
- eating until feel uncomfortably full
- eating when not physically hungry
- eating alone
- feeling guilty afterwards
C - marked distress regarding binge eating = functional impairment
D - average binge frequency must be at least 1/week for 3 + months
E - no regular use of inappropriate compensatory behaviours (lose calories)
BMI
- used to define normal weight
- w/h^2
bulimia nervosa criteria
when you vomit once you eat
A - recurrent episodes of binge eating
B - recurrent inappropriate compensatory behaviour (purging or non)
C - frequency both AB 1xweek for 3+ months
D - self concept unduly influenced by body shape/weight
difference between purging vs non-purging subtype
purging - vomiting or misuse of laxatives
non-purging - fasting or excessive exercise
anorexia nervose criteria
3 criteria
A - restriction of energy intake (having low BMI) by starvation, purging or exercising
B - intense fair of gaining weight even when under weight
C - any of the following
- denial of low body weight
- disturbance in perception of body weight/shape
- undue influence
society impacts on our body
- social expectations (eg. influences)
- body dysmorphia
- changing beliefs across time 9now a focus on positive body image)
te whare wha on eating disorders
whanua = family therapy/services
tinina = nourishing the brain and the body
wairua = values work
hinengaro = cognitive therapy
the history of pathopsychology
the worlds perspective has grown and changed, and there are now treatments that are effective in some settings
Taha hinengaro
emotional wellbeing
this is your thoughts, emotions and feelings
taha tinana
physical wellbeing
- your over all physical health
taha wairua
spiritual wellbeing
- your value system
- connections
- identity
taha whanau
social wellbeing
- your family
- healthy relationships and communications
- your role in your family
what is a disorder
- a psychological factor
- distress or impairment
- atypical response (getting in the way of life)
fight or flight
autonomic response to a threat via the sympathetic nervous system
differential diagnosis
when you show different symptoms for the same diagnosis
- assessment procedure
- comorbid disorders
- role of cultural specific anxiety
managing anxiety
a focus on skills and addressing what is giving you your anxiety
people with personality disorders are often referred for
anxiety
% have trouble getting back to sleep
% don’t feel refreshed
% have trouble falling asleep
50%
50%
30%
how can we help stress in maori
- understand the inequalities
- focus on their barriers to treatment
- bust myths
