Unit 4 AOS 2 Flashcards
Mental Wellbeing
The most common mental illnesses in Australia?
- Anxiety disorders (3.4 million people, or 17% of the population)
- Affective disorders (clinical depression, Bipolar - Disorder, Schizoaffecive disorder) (1.5 million, or 8%)
- Substance Use disorders (650,000, or 3%) (ABS 2023a).
Defining Mental Wellbeing
mental wellbeing is an individual’s psychological state of mind, including their ability to think, process information, and regulate emotions
what does being mentally healthy mean?
Being mentally healthy means being in a generally positive state of mental wellbeing, being able to manage life’s challenges, striving to fulfil one’s goals, and having a sense of connection to others
what is mental wellbeing more than?
It is more than the absence of mental illness.
what does good mental health mean?
Good mental health does not mean we do not have times of sadness, anger or anxiety, but in how well we deal with various stressors and events
how is mental wellbeing shown as?
Not considered something we have or not have; it is represented on a continuum
Ways of considering one’s mental wellbeing include?
→ Levels of Functioning
→ Resilience
→ Social and Emotional Wellbeing
define Levels of functioning
Refers to an individual’s ability to complete day-to-day task and meet everyday demands in an independent and effective manner
Examples of high levels of functioning
- Carry out everyday tasks (maintain personal hygiene, dressing appropriately, preparing food etc)
- Be productive in achieving tasks and participate in community
- Set goals and take steps towards achieving them
- Be independent* (*only relevant if you are physically and developmentally capable of doing so. Someone with a disability may require assistance to complete some day-to-day tasks, but that does not mean that they do not have high levels of mental wellbeing.)
- Adapt to changes in environment
- Meet challenges of school, work, relationships and daily activities (domestic responsibilities, leisure)
define cognition
understanding and communicating
define mobility
moving and getting around
define selfcare
hygiene, dressing, eating and staying alone
define getting along
interacting with other people
define life activities
domestic responsibilities, leisure, work and school
define participation
joining in community activities
What does ‘low levels of functioning’ look like?
- Struggle to carry out basic tasks, such as maintaining personal hygiene and dressing appropriately
- Lack direction or be able to set goals in life
- Feel uncharacteristically lethargic or tired and thus be unproductive in achieving tasks
- Be unable to cope with changes in the environment.
what may low levels of functioning lead to?
Low levels of functioning may lead to a sense of hopelessness, reducing an individual’s self-belief and, in turn, mental wellbeing
define Resilience
Resilience refers to the ability to cope with and manage change and uncertainty and ‘bounce back’ from adversity and restore positive functioning. In turn, resilience enables a person to overcome stressors and recover from challenges presented.
Individuals with high levels of resilience may?
- seek solutions to problems
- use appropriate coping strategies
- be flexible in changing circumstances
- be optimistic and hopeful
High levels of resilience can lead to a positive state of mental wellbeing because it can result in an individual having?
- high self-esteem
- more confidence in carrying out tasks
- increased coping flexibility, which enables them to adjust coping strategies to a range of stressors.
Individuals with low levels of resilience may?
- experience enduring feelings of being overwhelmed when problems arise
- rely on unhealthy or unhelpful coping strategies
- be unable to adapt to change
- lack hope and optimism
what doesn’t being resilient mean?
Being resilient does not mean that your life is without difficulty or distress, or that you are always happy.
what can high levels of resilience lead to?
Rather, high levels of resilience lead to mental wellbeing as you are able to respond effectively to stressors, overcome them, or adapt to them.
can resilience be taught?
Resilience is something that can be taught and developed over time and often results from seeking appropriate social support in times of stress.
define social wellbeing
Based on the ability to have satisfying relationships and interactions with others
Characteristics of social wellbeing?
- Develop and maintain healthy relationships
with family and friends - Ability to form new relationships
- Appropriate social interactions with others
- An ability to effectively communicate
- Competently resolve conflicts with others
- Effectively manage unhealthy relationships
- Feel self-confident alone or with others
define emotional wellbeing
Based on the ability to control emotions and express them appropriately and comfortably as well as understand the emotions of others.
Characteristics of emotional wellbeing?
- Develop awareness of own emotions
- Regulate and control emotions when appropriate
- Express a range of emotions (both positive and negative) in a suitable manner
- Identify emotions in others and empathise
- Accept mistakes and setbacks and learn from them
- Manage stress reactions using appropriate coping skills
A person with low levels of social wellbeing may?
- be isolated or lack support from others
- have difficulty forming and maintaining meaningful relationships
- struggle to effectively communicate with others
A person with low levels of emotional wellbeing may?
- be unable to understand or name their own and others’ emotions
- feel numb or be unable to experience certain emotions
- express emotions inappropriately or at inappropriate times (for example, yelling at your boss while at work)
what is the Social and Emotional Wellbeing (SEWB) framework for Aboriginal and Torres Strait Islander communities?
A framework that includes all elements of being and therefore wellbeing, for Aboriginal and Torres Strait Islander peoples
define Multidimensional
made up of different interacting components
define Holistic
an approach to wellbeing that considers the whole person, including their mental, physical, spiritual and social needs
what does the SEWB framework for Aboriginal and Torres Strait Islander communities consider?
considers wellbeing in a grounded collectivist approach
what does a grounded collectivist approach include?
- the self is viewed as significantly linked to family and community
- culture and cultural identity are also integral to achieving social and emotional wellbeing
- explores seven dimensions (sources) of wellbeing
what are the seven dimensions of SEWB framework for Aboriginal and Torres Strait Islander communities?
Connection to:
- Body
- Mind and emotions
- Family and kinship
- Community
- Culture
- Country
- Spirituality and ancestors
what influences the SEWB framework?
- The individual (self) within a network of relationships called ‘domains’ (or elements) and the quality of an individual’s connections (experiences and expressions) to these domains is what influences their social and emotional wellbeing
- Underpinned by social, political and historical determinants
describe Connection to Body?
Connecting to the physical body and health in order to participate fully in all aspects of life.
examples of Connection to Body?
- Maintaining a healthy weight
- Access to good nutrition
- Managing illness and disability
describe Connection to Mind and Emotions?
Ability to effectively manage thoughts and feelings.
examples of Connection to Mind and Emotions?
- Maintaining self-esteem
- Connecting to values and motivation
- Having high levels of confidence
- Maintaining a strong identity
describe Connection to Family and Kinship?
Connection to the immediate and wider family group and community.
examples of Connection to Family and Kinship?
- Spending time within family groups promotes a feeling of connection and therefore wellbeing.
- Caring for the ill is the responsibility of all, not simply one’s biological parents or children.
describe Connection to Community?
Connection to wider social systems, providing individuals and families the ability to connect with and support each other.
examples of Connection to Community?
- Community services and support networks.
- The ability to maintain community connections plays an integral role in maintaining the wellbeing of individuals
describe Connection to Culture?
A strong sense of identity, values, tradition, and connection between the past, present, and future that drives behaviour and beliefs.
examples of Connection to Culture?
- Elders passing on information and tradition to future generations.
- Speaking local languages.
- Attending cultural events.
- Participating in traditional rites and rituals, which enable children to learn about their culture’s value systems, including those related to wellbeing.
describe Connection to Country?
The traditional lands of a particular language or cultural group, both geographically and the spiritual, emotional, and intellectual connections to and within it.
examples of Connection to Country?
- Aboriginal and Torres Strait Islander beliefs are tied heavily to the land and how one lives on it. One should and does not take more than one needs so the land continues to thrive.
- Each person belongs to certain territories within family and clan groups, and by extension has spiritual connections and obligations to the associated land. Therefore, one belongs to the land rather than the other way around
- Connection to Country is a strong part of Aboriginal culture and therefore a strong part of establishing social and emotional wellbeing
describe Connection to Spirituality?
Spirituality refers to a concept that connects all things, and shapes beliefs, values, and behaviour. It guides knowledge systems, culture, and all that is life for Aboriginal people, including connections to ancestors, the past, the present, and the future.
describe Connection to Ancestors?
Ancestors refer to a belief that a family and community’s ancestors are interconnected with Creation spirits and Country and watch over, guide, and protect families and communities in the physical and spiritual world.
examples of Connection to Spirituality and Ancestors?
- Aboriginal and Torres Strait Islander peoples’ spirituality is grounded in the belief that their ancestors watch over them for the entirety of their life. There is a strong belief that ancestors will offer guidance when needed and answer questions in unique ways when least expected. This creates a sense of purpose and wellbeing
define Mental Wellbeing Continuum
Refers to a tool used to track fluctuating mental wellbeing ranging from high to low levels of mental wellbeing.
where are individuals placed on the Mental Wellbeing as a Continuum?
Every individual is placed at different points on the continuum at certain points.
is mental wellbeing fixed?
As mental wellbeing is a constantly changing (dynamic) state, an individual’s MW is not fixed and can shift over time.
where are individuals diagnosed with a mental illness placed on the mental wellbeing continuum?
Generally speaking, if an individual is diagnosed with a mental illness, they may be placed on the low levels of wellbeing end of the continuum, however if they are managing their condition well and have social support they may move towards higher levels of mental wellbeing.
what is placement on mental wellbeing continuum dependant and influenced by?
One’s placement is largely dependent on their levels of functioning. Is is also influenced by a range of internal and external factors.
what are the levels of mental wellbeing on a continuum?
- High levels of Mental Wellbeing
- Moderate levels of Mental Wellbeing
- Low levels of Mental Wellbeing
what does High levels of Mental Wellbeing involve?
- Able to function independently within their everyday life
- Manage emotions and feelings (high level of emotional wellbeing)
- Can form positive relationships with others (high level of social wellbeing)
- Have the resilience to cope with and manage change and uncertainty
- Think logically and problem solve
- Have reasonable levels of confidence in their abilities and self-esteem.
- Able to cope with everyday demands without showing an excessive level of distress and dysfunction
what do people with high levels of mental wellbeing still experience?
Still may experience stress, sadness, and anger, however, have high levels of mental wellbeing due to their ability to cope with these experiences, regulate emotions, and express them appropriately.
what is high levels of wellbeing also known as?
‘Mentally Healthy’
what does Moderate levels of Mental Wellbeing involve?
- is not functioning at an optimal level
- experiences a temporary or moderate impact on mental wellbeing
- experiences amplified emotions and high levels of stress
- has difficulty concentrating
- is more likely to experience irrational thought patterns.
- experience changes in sleep and appetite
- experience a loss of energy and motivation
- socially withdraw
how does moderate levels compare to low levels of mental wellbeing?
Compared to experiencing extremely low levels of mental wellbeing, the causes and impacts of being in the middle of the continuum tend to be less severe and more temporary in nature.
what is moderate levels of wellbeing also known as?
‘Mental health Problem’
what does Low levels of Mental Wellbeing involve?
- shows high levels of distress,
- deviance (relates to thoughts and behaviours that are inconsistent with the person’s culture or society, - including actions such as speaking out of turn, lashing out at others and socially withdrawing)
- significant changes in thoughts, feelings and behaviours or a lack of interest (apathy)
- Dysfunction (unable to independently complete tasks and meet the demands of their environment. Including day-to-day functioning
- is impacted for an extended period (more than two weeks or in line with advice from mental health professionals). More longer lasting, and can be permanent.
- may be diagnosed by a mental health professional and may be treated through psychotherapy or medication.
- reduced ability to cope with and manage change and uncertainty
- impaired ability to engage in social relationships
- Serious or prolonged changes in typical character
what is low levels of wellbeing also known as?
‘Mental health Disorder’
Factors influencing Mental Wellbeing?
At any given time, a person’s position on the continuum is influence by both internal and external factors
define Internal factors
factors that arise from within the individual
define External factors
factors that arise from the individual’s environment
what is the biopsychosocial model based on and how is it useful?
The biopsychosocial model is based on the idea that mental wellbeing is influenced by a close interaction between biological, psychological and social factors. This can be a useful way of thinking about the range of internal and external factors that influence mental wellbeing
what can the three factors of the biopyschosocial model be catergorised as?
These three factors can be categorised as internal (biological and psychological) or external (social)
what are the Internal Factors Influencing Mental Wellbeing?
Biological factors and Psychological factors
define Biological factors
functioning of a person’s body and its systems
examples of biological factors?
- Genetic predisposition
- Sex
- Neurotransmitter function
- Hormones
- Immune function
- Nervous system activity
- Physical health
- Response to Medication
define Psychological factors
mental processes (cognition, emotion, perception) often related to prior learning experiences and memory
examples of Psychological factors?
- Styles of thinking
- Beliefs and attitudes
- Emotions
- Learning and memory
- Personality traits
- Attitudes
- Rumination (dwelling / repeated negative thoughts)
- Self-efficacy (belief in own abilities)
what mental illnesses are more prevalent in women compared to men?
Women have a significantly higher frequency of depression and anxiety in adulthood, while men have a larger prevalence of substance use disorders and antisocial behaviors.
what are the External Factors Influencing Mental Wellbeing?
Social factors
define Social factors
conditions in which an individual lives and grows (ie. their environment
examples of Social factors?
- relationships
- early life experience
- education level
- income
- social support
- stability of accommodation
- experience of abuse
- cultural values
- employment
- Discrimination & stigma
- Poverty
define stress
Stress is a psychological and physiological experience that occurs when an individual encounters a stressor that demands their attentions and/or efforts to cope
what can stress involve?
Stress can involve both positive (eustress) and negative (distress) feelings
define anxiety
Anxiety is a psychological and physiological response that involves feelings of worry and apprehension about a perceived threat
when can anxiety occur?
Can occur even when stressors are not necessarily present.
what is anxiety directed towards?
Usually directed towards something in the future (potential threats, dangers, negative events)
symptoms of anxiety?
Symptoms can include heart palpitations, muscle tension, shaky hands, dry mouth etc. These are caused by activation of the fight-flight-freeze response.
what feelings are involved in anxiety?
Anxiety is typically only negative feelings (distress)
what are stress, phobia and anxiety categorised as?
Stress, phobia and anxiety are psycholpogical constructs that have many similairities and as such can be difficult to distinguish between them.
when will people experience stress and anxiety?
People will experience stress and anxiety from time to time and are expected part of daily life
how can some stress and anxiety be categorised as?
Some stress and anxiety can be adaptive for functioning as they can motivate people to take action; e.g. preparing for an exam instead of avoiding it.
what happens when stress and anxiety becomes bad?
BUT, when anxiety is excessive, persistent over a long period of time and disrupts daily functioning, it can become a mental health disorder (Anxiety disorders – chronic feelings of extreme apprehension, fear, unease)
how are phobias sectioned?
Phobias are a subset of anxiety disorders, with specific phobias being a further subset of phobias
define specific phobia
Specific phobia (sometimes referred to as phobia) is defined as a persistent, irrational and excessive fear or anxiety in response to a specific object or situation
what fear response is normal?
Exhibiting a fear response to an object or event is normal, as long as it is rational.
what is fear from an evolutionary perspective?
From an evolutionary perspective, humans are genetically predisposed to be of afraid of things that pose a threat to us to help us survive.
how can you be diagnosed with a specific phobia?
However, if the fear response interferes with a person’s functioning e.g. they avoid any situation involving the object or event to avoid any distress – that person may be diagnosed with specific phobia (has to significantly disrupt their daily functioning)
what happens when someone encounters their specific phobia?
Whenever the person encounters or even thinks about the object or event, they may experience the acute physiological around associated with the fight-flight-freeze response.
are sufferers aware of their phobic responses?
Generally, sufferers know that their fear is grossly in excess of any real danger posed by phobic stimulus, but cannot control this fear. In some cases, a person’s exposure to a phobic stimulus can result in a panic attack.
what are the general categories of specific phobias?
- Animals; spiders, dogs, insects, birds, fish, mice
- Situational; aeroplanes, elevators, enclosed spaces, tunnels
- Natural environment; heights, storms, darkness, lightning, being near water
- Blood-injection-injury; seeing blood, having blood taken, injections, getting a cut
- Other phobias; choking, vomiting, loud noises, clowns, dying, becoming ill
what are the characteristics of phobias?
- The phobia is excessive
- The sympathetic nervous system is dominant
- Avoidance of the phobic stimulus
- Distressing for the individual
- The phobia is irrational
- Diagnosable mental disorder
- Fear of phobic stimulus affects daily functioning
- The feeling of fear is predominant
- The phobia is persistent
- The response is to a known stimulus
where are stress, phobia & anxiety on the mental wellbeing continuum?
Stress and anxiety are within the normal range of functioning on the mental health continuum, whereas phobia is a mental health disorder (ie. low levels of mental wellbeing)
can the responses of stress, phobia and anxiety be distinguished?
Both the physiological and psychological responses of stress, phobia and anxiety are similar
how are stress, phobia and anxiety characterised?
All 3 are characterised by the same physiological markers, as the sympathetic nervous system is activated. These include: increased heart rate, increased perspiration, rapid breathing, dilated pupils
what is key difference of specific phobia and anxiety?
A key difference of specific phobia and anxiety is that phobias are in response to a specific phobic stimulus whereas anxiety is often more generalised.
compare the systems of stress, phobia and anxiety?
stress - Sympathetic nervous system becomes dominant
anxiety - Sympathetic nervous system becomes dominant
specific phobia - Sympathetic nervous system becomes dominant
compare what stress, phobia and anxiety are responses to?
stress - The response is to a known stimulus (stressor)
anxiety - Response may be to an unknown stimulus or generalised
specific phobia - Response is to a known stimulus (phobic stimulus)
compare the feelings of stress, phobia and anxiety?
stress - Feelings can be either positive (eustress) or negative (distress)
anxiety - Distress only – feelings of apprehension, unease, worry
specific phobia - Distress only – feeling of fear is predominant
compare the adaptiveness of stress, phobia and anxiety?
stress - Some stress can be adaptive
anxiety - Some anxiety can be adaptive/helpful
specific phobia - Maladaptive
compare the ‘normality’ of stress, phobia and anxiety?
stress - Considered ‘normal’ to experience in certain situations
anxiety - Considered ‘normal’ to experience in certain situations
specific phobia - Not considered ‘normal’
compare stress, phobia and anxiety on the continuum?
stress - fluctuates between low to high levels of mental wellbeing, depending on the severity and length of time
anxiety - fluctuates between low to high levels of mental wellbeing, depending on the severity and length of time
specific phobia - associated with low levels of wellbeing
compare stress, phobia and anxiety with mental health disorders?
*Stress and anxiety can contribute to/develop into mental health disorders if not managed; phobia is a diagnosable mental illness
what are the contributing factors to the development of specific phobia?
BIOPSYCHOSOCIAL, so biological, psychological and social factors
BIOLOGICAL CONTRIBUTING FACTORS?
- GABA Dysfunction
- Long-Term Potentiation
PSYCHOLOGICAL CONTRIBUTING FACTORS?
- Precipitation by classical conditioning
- Perpetuation by operant conditioning
- Cognitive Biases (Memory bias & catastrophic thinking)
SOCIAL CONTRIBUTING FACTORS?
- Specific environmental triggers
- Stigma around seeking treatment
define GABA Dysfunction
Refers to a failure to produce, release or receive the correct amount of GABA (ie. insufficient neural transmission or reception of GABA).
what is GABA?
GABA is the main inhibitory neurotransmitter in the CNS, It makes post-synaptic neurons less likely to fire.
what does GABA regulatate?
GABA regulates postsynaptic activation in neural pathways. Preventing over-excitation and uncontrolled firing.
what does GABA act like?
Acts like a calming agent or ‘brake’ for anxiety as it halts the neural impulse responsible for the FFF response.
what does low levels of GABA mean?
Low levels of GABA makes people vulnerable to anxiety disorders as neurons start firing uncontrollably (ie. Increases firing)
what do people with naturally lower GABA have?
People with naturally lower GABA levels tend to have a more sensitive fight-flight-freeze response (ie. the response is activated more easily, therefore the stress response is more easily triggered) which will increase their likelihood of developing a phobia
what can recurrent stress responses to specific stimuli lead to?
Additionally, recurrent stress responses to specific stimuli (e.g. snakes) can lead to the development of of a phobia.
what are GABA levels influenced by?
GABA levels influenced by genetic inheritance, CNS damage, exposure to prolonged stress, nutritional deficiencies in vitamin B6 and citric acid and high caffeine intake.
what does low levels of GABA lead to?
When a person has low levels of GABA, the increased presence of glutamate (main excitatory neurotransmitter) increases agitation and anxiety can lead to formation of a specific phobia
what are the steps of GABA dysfunction?
Involves GABA not binding properly to receptor sites
steps to developing a phobia with GABA dysfunction?
- GABA dysfunction
- Increased activation of the flight or fight or freeze response
- More likely to develop a phobia
define long term potentiation
Long term potentiation is the long-lasting and experience-dependent strengthening of synaptic connections that are co-activated.
what does fear and stimulus associate in long term potentiation?
When we associate fear with a particular stimulus, new neural connections will form and strengthen in the amygdala.
how does long term potentiation contribute to a phobia?
This contributes to the development of phobias as LTP strengthens the association between neural signals involved in perceiving a phobic stimulus (e.g. snakes) and neural signals involved in the fear/anxiety response to the phobic stimulus through repeated co-activation of the same neural pathways.
how does long term potentiation perpetuate phobias?
The more these connections are activated (i.e. through different encounters), the stronger the phobia (and associated fear response) becomes.
steps of long term potentiation contribution to phobia?
- fear response neural pathway and perception of phobic stimulus neural pathway are co-activated
- repeated co-activation
- strengthens phobic response
what are the types of psychological contributing factors?
- Behaviour models
- Cognitive biases
define precipitating factors
The immediate factors/events that contribute to the occurrence of a mental disorder. They generally precede/trigger the onset of the disorder.
how can phobia’s be developed psychologically?
Phobias can be developed/learned through classical conditioning
how can precipitation through classical conditioning contribute to phobia’s?
Precipitation by CC can contribute to the development of phobias by increasing susceptibility to and contributing to their occurrence
how does precipitation through classical conditioning occur?
- Occurs through the repeated pairing between NS and UCS to produce the UCR until the CS alone produces the CR.
- If its a highly traumatic situation, it can be a one-off pairing too.
- The phobic stimulus (e.g. spider) would previously be the NS
define Perpetuating factors
Longer-term, ongoing factors that maintain the mental disorder and inhibit recovery. They cause a person’s symptoms to continue or progressively worsen.
how are phobia’s perpetuated by operant conditioning?
When someone avoids their phobic stimulus they feel a sense of relief.
what does avoidance act as for phobia’s?
This acts as a form of negative reinforcement that increases the likelihood of the avoidance behaviour being repeated in the future.
what other consequences can reinforce phobia’s?
Can also be positively reinforced, if some sort of reward/praise etc is received by others in response to the behaviour associated with the phobia
how does operant conditioning contribute to phobia’s?
Perpetuates (inhibits recovery) by preventing ability to overcome the fear through avoidant behaviours
how does reinforcement strengthens phobia’s?
reinforcement strengthens or maintains the phobic response making avoidant behaviours more likely to be repeated
what is a recap of operant conditioning?
operant conditioning is a form of learning through the association of behaviour and consequence it receives
ABC steps of perpetuation by operant conditioning for phobias?
A - phobic stimulus
B - Individual avoids phobic stimulus
C - Individual avoids fear response (Negative reinforcement - Behaviour is negatively reinforced due to the avoidance of an aversive stimulus (fear response))
define cognitive bias
A cognitive bias is a way of thinking that involves judgement errors and/or faulty decision-making and alters our perception of objects or events.
what are the types of cognitive biases?
- memory bias
- catastrophic thinking
define memory bias
A form of cognitive bias caused by inaccuracy or exaggeration in the recall of an event
what does memory bias cause?
Allows phobias to persist over time
define catastrophic thinking
Occurs when an individual overestimates the potential dangers and assumes the worst.
what does catastrophic thinking cause?
- Causes people to feel helpless and underestimate their ability to cope with a situation.
- Makes phobic stimuli seem worthy of extreme fear and anxiety
socially what factors can contribute to phobias?
Social and cultural factors can contribute to the development of a specific phobia.
what connection has research found between parents and children with phobias?
Research has found that a child whose parent suffers from a phobia of spiders, for example, is more likely to develop the same phobia as a result of simply observing their parent’s fear response and making the cognitive connection that ‘spiders are dangerous’.
who socially can contribute to phobias?
Family and friends may contribute to the perpetuation of the phobia by encouraging avoidant behaviour of situations where the object of the phobia may be encountered.
what are the two social contributing factors to phobias?
Two social contributing factors you should know include environmental triggers and stigma around seeking treatment
how can specific environmental triggers influence phobias?
In many instances, specific environmental triggers can lead to the development of a specific phobia, through experiences in a person’s environment that prompt an extreme stress response.
what are the types of specific environmental triggers?
- Direct exposure (direct confrontation)
- Observing other people (observation)
- Learning about (learning/indirect confrontation)
define the specific environmental triggers of direct exposure
Direct exposure to a distressing or traumatic event
define the specific environmental triggers of observing other people
Observing other people experiencing a traumatic event
define the specific environmental triggers of learning about
Learning about potentially dangerous or traumatic stimulus or event directly
define Stigma around seeking treatment
sense of a shame or social disapproval a person might feel about getting professional help
what can phobias cause socially?
Phobias can cause irrational responses which are viewed negatively by others.
what happens if you don’t treat a phobia?
Leaving one’s phobia untreated also contributes to the development and maintenance of specific phobia
why do people not seek help for phobias?
Often people will not seek help due to embarrassment, fear or worry and believe that people can’t empathise with them or think they are ‘crazy’.
is it easy for people with phobias to seek help?
As phobias are based on at least somewhat irrational fears, seeking help can be very difficult
what can treatment stigma do?
- Treatment stigma can precipitate (cause) a phobia (start avoiding stimulus and then worsen fear response and develop into phobia)
- Can perpetuate phobias (act as a barrier), as sufferers are afraid to ask for help
what can concern over seeking treatment cause?
Concern over seeking treatment can cause (precipitate) a specific phobia. E.g. if someone slightly afraid of feathers they may actively avoid them and this can actually make the fear response develop into a phobic response.
what can stigma act as?
Stigma can act as a barrier to seeking treatment, hence perpetuating phobias. Sufferers can be afraid to ask for help or admit it to family/friends for fear of being ridiculed.
what are the types of evidence based interventions for phobias?
Biopsychosocial intervention:
- Biological interventions
- Psychological interventions
- Social interventions
what are the biological interventions?
- Short-acting benzodiazepines (GABA agonists)
- Breathing retraining
what are the psychological interventions?
- Cognitive behavioural therapy (CBT)
- Systematic desensitisation
what are the social interventions?
Psychoeducation, which is further subdivided into challenging unrealistic or anxious thoughts and not encouraging avoidance behaviours
define agonists
Agonists are drugs that stimulate / mimic the activity of a neurotransmitter
when are agonists prescribed?
Prescribed when person has a deficiency of something as means of increasing the level
define antagonists
Antagonists are drugs that inhibit/block the activity of a neurotransmitter
when are antagonists used?
Used when a person has too much of something as a means of reducing the level
define benzodiazepines
Benzodiazepines are agonist drugs that work on the CNS. E.g. Valium Xanax, a.k.a ‘anti-anxiety medication’
how do benzodiazepines work?
- They mimic the effects of GABA (GABA Agonists) and can be used to reduce anxiety levels
- They increase GABA’s inhibitory effects and make post-synaptic neurons less likely to fire
what do benzos bring about?
Benzo’s bring about a state of calm by reducing
overactivity in the brain by reducing physiological
arousal and promoting relaxation.
what can benzos be used as?
Can be used as sedatives and muscle relaxants
how do benzos reduce symptoms?
Reduces the symptoms of anxiety by amplifying the influence of GABA’s inhibitory effects on the postsynaptic neuron.
strengths of benzodiazepine agents?
- Highly effective in reducing symptoms in a wide variety of people
- Can help alleviate symptoms so that root causes of the phobia can be more effectively treated with other therapies like CBT
- Quick effect so good to take just before a stressor is anticipated, e.g. before flying
how do benzos adapt to receptors?
- changes the shape of the receptor to make it more receptive to the activity of GABA and consequently more resistant to excitation.
- Works with GABA receptors in the brain
- The body will stop producing GABA if too much is taken
weaknesses of benzodiazepine agents?
- They do not treat the underlying cause of the phobia; only treats symptoms
- Can be highly addictive, so only for short term use
- Can result in withdrawal effects after prolonged use
- Side effects - reduced alertness, drowsiness, slower reaction times (particularly if mixed with alcohol)
- Reduced inhibition increasing possibility of risk-taking behaviour
- Interestingly, people who take them for an extended period of time start reporting increased levels of anxiety
what type of technique is breathing retraining?
Relaxation techniques
define breathing retraining?
Breathing retraining is a relaxation technique that involves identifying incorrect breathing habits and replacing them with more helpful ones.
what happens to breathes when people get stressed?
When a person is stressed they may breathe deeper or take small, shallow breaths (hyperventilation)
what does hyperventilation cause?
This can cause an imbalance in oxygen and carbon dioxide levels in the blood which can result in dizziness, blurred vision or heightened anxiety symptoms and other symptoms associated with the FFF response.
what can breathing retraining decrease?
This can decrease a person’s overall level of anxiety when anticipating or being exposed to a phobic stimulus.
what types of breathing is used in breathing retraining?
E.g. Breathe from diaphragm (not nose) in a slow, regular manner.
what can breathing retraining help lower?
Can help lower HR, BP and stress hormones.
what can breathing retraining help enhance?
Enhances energy levels and improves immune system functioning.
what is an advantage of breathing retraining?
An advantage is that a person can use their correct breathing technique in public situations without drawing much attention.
what is a disadvantage of breathing retraining?
However, breathing retraining also needs to be practiced, especially when not particularly anxious, in order to make it
Two main steps involved in breathing retraining?
- A therapist/doctor will teach a person with a specific phobia how to consciously control their breathing, including slow and deep inhalations, followed by slow and controlled exhalations. Counting slowly when breathing in and out
- The learner applies these breathing techniques when in the presence of a phobic stimulus in order to reduce sympathetic responses and anxiety. This restores the amount of oxygen in the body to an optimal level and help the parasympathetic nervous system become dominant.
define Cognitive Behavioural Therapy (CBT)?
CBT is a form of psychotherapy which encourages individuals to change unhealthy, negative and dysfunctional thoughts and behaviours and replacing them with adaptive, positive, realistic ones.
what has research shown about CBT?
Research has shown CBT is the most effective method of treating specific phobia.
what does CBT help treat?
Helps treat the underlying phobia and not just the symptoms of it
in CBT what are unhealthy cognitions/thoughts that may contribute to and perpetuate phobia?
- Memory bias
- Catastrophic thinking
- A belief that the phobia can never be overcome
- Belief that the phobia will get worse
- Embarrassment
- Fear
in CBT what are unhealthy behaviours that may contribute to and perpetuate phobia?
- Avoidance behaviour of phobic stimulus at all costs
- The biological stress response
- Not seeking help
- Avoiding social activities that may expose a person to their phobia
what can unhealthy cognitions and behaviours do?
The presence of these cognitions and behaviours can mutually reinforce each other and perpetuate a phobia.
what is the cognitive component of CBT?
involves using information to overcome irrational thoughts, with more realistic thoughts and challenge cognitive biases. E.g. might be asked to find evidence to challenge their fears as well finding refuting evidence, consider the statistical likelihood of their fear (e.g. likelihood of the plane crashing)
what happens in CBT once the person has done the cognitive component?
Once the person has identified their cognitive distortions and evaluated the evidence they are more able to counter them with more objective, useful and accurate thoughts, leading to changes in feelings and behaviours (e.g. avoidance)
what is the behavioural component of CBT?
involves modifying unhelpful, maladaptive avoidance behaviours. E.g. employing relaxation training (breathing retraining, exercise, meditation) and systematic desensitisation
define Systematic Desensitisation
a therapy technique used to overcome phobia by involving patient being exposed incrementally to increasingly anxiety-inducing stimuli, combined with the use of relaxation techniques
what is Systematic Desensitisation also known as?
Also known as graduated exposure therapy
how does Systematic Desensitisation work?
*Remember, many phobias are acquired through classical conditioning.
**Systematic desensitisation operates on the principles of CC aiming to de-condition the association between the phobic stimulus and fear, by associating with phobic stimulus with relaxation (a positive stimulus)
what can Systematic Desensitisation involve?
Can involve visual imagery, a virtual reality device or reality
steps of Systematic Desensitisation?
- Learning relaxation techniques such as breathing re-training
- Create a fear hierarchy of the phobic stimulus from least to most difficult to confront
- Gradual exposure to each item in fear hierarchy
- Continuation of systematic exposure until the most fear inducing stimulus can be faced without the phobic response
what is the step of learning relaxation techniques such as breathing re-training?
a therapist might teach a patient breathing techniques to reduce physiological arousal and fear and produce relaxation response
what is the step of create a fear hierarchy of the phobic stimulus from least to most difficult to confront?
creating a list of anxiety-inducing experiences related to the phobia in order of easiest to confront to most difficult. (e.g. reading about bugs 🡪 directly touching a bug)
what is the step of gradual exposure to each item in fear hierarchy?
slowing working through the bottom of the fear hierarchy to the top – each step is paired with the relaxation technique identified in step 1
what is the step of continuation of systematic exposure until the most fear inducing stimulus can be faced without the phobic response?
After repeated associations, the phobic stimulus (CS) will now elicit a relaxation response (CR).
how do people progress through systematic desensitisation?
Cannot move to next level until fear is eliminated at each level
what are limitations of systematic desensitisation?
- Difficult to use if the person faints when exposed to their phobic stimulus (e.g. blood phobia).
- It may not be effective in treating phobia that has an underlying evolutionary survival element (e.g fear of spiders, fear of the dark)
- Not as effective for treating social phobia or agoraphobia.
- Can be quite a slow process and needs to be completed for a period of time to ensure phobias
aren’t worsened
what is a problem of systematic desensitisation?
If the phobia continues and starts to associate phobias with the song and the relaxation technique – very important to take it slow
define Psychoeducation for family/supporters and the sufferer
Providing information to family/friends about a mental disorder so that they are better able to support someone suffering from a condition.
what does psychoeducation help reduce?
It also helps to reduce stigma associated with the condition.
what education does psychoeducation include?
Education will include information on the nature of the illness, treatment options and the role of support networks.
what does psychoeducation include?
- Challenging unrealistic or anxious thoughts
- Not encouraging avoidance behaviours
what do people with phobias tend to do?
- People with phobias tend to overestimate the dangers and underestimate their coping abilities in relation to their phobia.
- Cognitive distortions occur, e.g. memory bias and catastrophizing.
how can family and friends help with psychoeducation?
Friends/families can ask questions to challenge thoughts, e.g. what’s the probability of this happening? Where is your evidence to support it? Is there a better way to think about it?
how does challenging unrealistic anxious thoughts help?
This will help them challenge unrealistic thoughts and replace them with more rational ones
factors of not encouraging avoidance behaviours?
- Avoidance behaviours prevent exposure to the phobic stimulus.
- They are maladaptive because it perpetuates the disorder by negatively reinforcing the behaviour.
- Supporters should encourage more adaptive alternatives
how can family and friends help with challenging unrealistic anxious thoughts?
- Challenging unrealistic thoughts can be difficult when anxious or distressed.
- Families and other supporters can play an important role to play in helping a person to cope /overcome a phobia by encouraging them to recognise and challenge unrealistic or anxious thoughts.
how can family and friends help with not encouraging avoidance behaviours?
- Often, family members and supporters encourage or reinforce avoidance behaviours.
- Counterproductive - may actually be contributing to the phobia unintentionally.
- Appropriate techniques would include encouragement, praise, companionship, support, remaining calm and patient.
define Protective Factors
Influences that enable an individual to promote and maintain high levels of mental wellbeing as well as prevent the occurence or re-occurence of mental disorders.
what are the factors for protective factors?
- biological
- psychological
- social
components of protective factors?
- Reduce the risk of low levels of mental wellbeing or developing a mental health disorder
- Increase the likelihood of high levels of mental wellbeing
- protective factors do not guarantee high levels of mental wellbeing
Biological Protective Factors?
- Adequate nutrition and hydration
- Sleep
Psychological Protective Factors?
- Cognitive behavioural strategies
- Mindfulness meditation
Social Protective Factors?
- Support from family, friends and community that is authentic and energising
define Adequate nutrition and hydration
when the type and amount of food and drink that an individual consumes meets their physical needs
what does Adequate nutrition and hydration provide?
- Nutritional foods provide the body energy to function day-to-day and adapt to, and overcome, stressors.
what does Adequate nutrition and hydration promote?
Promotes wellbeing and resilience
what does Adequate nutrition and hydration include?
- Includes having a balanced diet
E.g. A Mediterranean diet (high amounts of fruits and vegetables, legumes, nuts and seeds and very low amounts of processed foods, sugar, sodium and fats) - 2 – 3 litres of water per day
why is adequate sleep important?
- Adequate sleep is important for wellbeing, good sleep likely reduces the likelihood of mental health disorders and promotes mental wellbeing.
- Adequate sleep prepares an individual for day-day life and results in individuals being less irritable and less likely to be ill. This also contributes to resilience.
- Sleep is important for restoring and recovering both the body (NREM) and brain (REM)
what relationships do the biological protective factors have with mental wellbeing?
Both adequate nutrition and hydration, as well as sleep, have a bidirectional relationship with mental wellbeing. This means that while nutrition and sleep can influence mental wellbeing, mental wellbeing can influence nutrition and sleep
define Cognitive behavioural strategies
technique that utilise traits of cognitive behavioural therapy, particularly recognising and changing dysfunctional thought and behavioural patterns
how does Cognitive behavioural strategies help?
- Awareness of these techniques allows the individual to recognise and change thoughts and behaviours
E.g. if someone is stuck in catastrophic thinking patterns, they could be taught to think more realistically and focus on problem solving, becoming more aware of differentiating between productive and unproductive worries, being taught relaxation and breathing techniques.
define Mindfulness meditation
the practice of meditation in which an individual focuses on their present experience to promote feelings of calm and peace
what does mindfulness meditation involve?
- Involves a person focusing their attention on their breathing, thoughts, feelings and sensations which are experienced freely as they arise.
- Involves being attentive and accepting of thoughts, feelings, sensations etc.
what does mindfulness meditation do?
- Brings awareness to what you are directly experiencing via your senses or to your state of mind via your thoughts and emotions
- Improves emotional reactivity
- Reduces the likelihood of rumination (repeated negative thinking)
- Reduces stress
- Improves memory
- Allows greater focus
- Boosts working memory
define Support from family, friends and community that is authentic and energising
genuine and effective assistance provided by family, friends, and community
define Authentic
genuine, down-to-earth, real
define Energising
provides vitality, enthusiastic
how does support as a protective factor assists individuals?
Assists an individual to overcome challenges without feeling overwhelmed and develop/maintain resilience
what must the support be as a protective factor?
Must be authentic and energising, therefore must:
- Genuinely aim to promote mental wellbeing
- Be focused on creating an environmental that is likely to improve mental wellbeing
- Use legitimate and effective advice
what must connections be socially for protective factors?
Connections must be authentic - e.g. connections via social media can be superficial.
what do authentic forms of support and connection provide?
Authentic forms of support and connection should provide you energy to flourish and go about your day-to-day life and dont leave you feeling depleted.
Examples of support from family?
- Unconditional love when an individual makes a mistake
- Regular catch-ups to vent emotions and share life details
- Familiar perspectives to go back to in times of uncertainty
- Support in difficult times, both emotionally and practically
- A sense of belonging to a relatively static and familiar group
- Encouragement to change and avoid unhealthy behaviours
Examples of support from friends?
- Fun and energising experiences
- Levels of intimacy and closeness that a person might not have with their family
- Support in difficult times, for example through providing distractions from difficult emotions, or assistance with self-care
- Reduction of stress and an increase in happiness
- A sense of belonging
- A sense of purpose
Examples of support from community?
- Opportunities for interaction and bonding, such as at clubs for specific interests or at events like festivals
- A sense of belonging and connectedness to a wider social circle
- A sense of moral accomplishment, achieved by participation in collaborative community projects
- Opportunities for personal growth and learning, such as at workshops and clubs
- Facilities and services for support, such as financial and medical assistance, or support for psychological difficulties, such as groups for parenting or overcoming grief
what are the Cultural determinants of wellbeing for Aboriginal and Torres Strait Islander peoples?
cultural continuity and self-determination
define Determinant of wellbeing
factors that influence wellbeing on individual and community levels
why is culture important for wellbeing?
- Culture is an important determinant of wellbeing
- Culture provides a sense of belonging and influences people’s identity
- People want their culture to be preserved and passed onto future generations
- For Aboriginal and Torres Strait Islander peoples culture involves a strong sense of identity, values, tradition, connection between past, present and future that drives behaviour and beliefs
define Cultural continuity
the passing down and active practice of cultural knowledge, traditions and values from generation to generation
define Self-determination
the rights of all peoples to pursue freely their economic, social and cultural development without outside interference (the right to make decisions on matters that affect their lives and communities, such as political matters, social, economic and cultural development)
how can Cultural continuity be achieved?
Can be achieved through a variety of cultural practices, including engaging with arts, crafts, music, dance, theatre, writing, storytelling, languages, food etc.
what does the SEWB framework explore?
This framework explores seven dimensions, or sources, of wellbeing that enable a strong and positive Aboriginal or Torres Strait Islander identity. These dimensions, although separated i the framework, are all interconnected.
examples of phobias?
Acrophobia – phobia of heights
Aerophobia – phobia of flying
Claustrophobia – enclosed spaces
Arachnophobia – spiders
Hematophobia – blood
where do Stress, phobia & anxiety on the mental wellbeing continuum from highest to lowest?
- stress (Moderate levels of functioning)
- anxiety (Moderate levels of functioning)
- specific phobia and Anxiety Disorders (Low levels of functioning)
how can Cultural continuity be disrupted?
Can be disrupted or destroyed with cultural practices are not allowed
what has research demonstrated about cultural continuity?
Research has demonsrated that strengthening cultural identify acts as a buffer against psychological stress, intergenerational trauma, self-harm and suicide.
what did colonisation do to cultural continuity?
Colonisation and dispossession meant that cultural continuity was challenged
what are the aboriginal cultural connections?
- COUNTRY
- PERSONAL IDENTITY
- FAMILY, CLAN &
COMMUNITY - HISTORY
- SYMBOLIC
- CULTURAL EXPRESSION
& EVENTS - CULTURAL
VALUES, BELIEFS & PRACTICES
what endeavours do self determination involve?
- Aboriginal community-controlled organisations
- Established partnerships between communities, governments and non-government organisation, which is any not-for profit organisation that exists to address a political or social issue
- Constitutional recognition for Aboriginal and Torres Strait Islander peoples.
what aspects are important for self determination?
Autonomy (the ability to self-govern and make one’s own decisions) and independent are important aspect
what does self determination enable?
Enables communities to protect what is most important to them
what did colonisation do to self determination?
Colonisation and dispossession meant that self determination was lost
how can self determination be exercised?
can be exercised: through our own representative bodies. through our own schools, justice systems, health systems. by having control over our lives.
what does breathing retraining act to do?
Breathing retraining acts to reduce physiological arousal associated with fear/anxiety/phobic response/restore balance of oxygen/carbon dioxide/regulate breathing rate/activate parasympathetic response.
