Unit 4 AOS 2 SAC - Mental Health

Question 1

Explain the concept of mental health as a continuum

stages, constantly changing

Answer 1

The mental health continuum involves the progression of levels of mental health. This ranges from an individual being mentally healthy, to having a mental health problem, and finally, to having a mental health disorder. It’s a tool used to track progression of mental health which constantly fluctuates over time, progressing from one stage to another.

Question 2

Distinguish between a:

• mentally healthy person
• a mental health problem
• mental disorder

Answer 2

The state of being mentally healthy is at one end of the continuum. This end of the continuum describes individuals who are able to independently and effectively function within their everyday life. This includes coping with the everyday demands of life without showing an excessive level of distress and dysfunction.
Characteristics of a mentally healthy individual include:
• High levels of functioning
• Able to cope with stress
• Able to meet the demands of everyday life and be productive
• Displays resilience
• Maintains positive relationships with others
• Able to regulate emotions and express them appropriately

Mental health problems involve a degree of disturbance or dysfunction within an individual which reduces their ability to function at an optimal level. Mental health problems can have a negative and considerable impact on an individual’s daily functioning. However, in comparison to a mental health disorder, this impact is less profound and typically only experienced temporarily.
Characteristics of a mental health problem include:
• Not functioning at an optimal level
• Temporary impact on mental health
• Experiencing amplified emotions and high levels of stress
• Difficulty concentrating and experiencing irrational thought patterns

Mental health disorders cause severe and profound disturbances to an individual’s ability to function. When experiencing mental health disorders, individuals are not likely to be described as mentally healthy due to showing high levels of distress, being unable to independently complete tasks and meet the demands of their environment. Individuals with mental health disorders typically display behaviour which does not meet the norms of society and may be deemed as inappropriate.
Mental health disorders are diagnosable and may be treated through psychotherapy or medication.

Question 3

Define mental health

Answer 3

An individual’s mental health, or their current psychological state of functioning and wellbeing, constantly fluctuates over time. This leads to individuals being placed at different points on the mental health continuum over their lifetime.

Question 4

Example of a mental health problem

year 12 exams

Answer 4

Example:
An individual is unable to cope with their year 12 exams. During this time, this individual may be unable to sleep because of their intense stress and may be constantly crying. However, after the exams finish, the individual is able to restore independent functioning. For this reason, the temporary and less severe nature of this individual’s dysfunction demonstrates that they would most likely be placed on the mental health problem category on the continuum, rather than at the mental health disorder category.

Question 5

Example of a mental disorder

anxiety disorders

Answer 5

One example of a mental health disorder is an anxiety disorder. This type of mental health disorder is characterised by an extreme level of distress which significantly disrupts an individual’s daily functioning and ability to cope with the demands of their everyday life.
Individuals diagnosed with an anxiety disorder may experience panic attacks and irrational thoughts, indicating that they may not be considered mentally healthy.

Question 6

Internal factors
Define
Examples

Answer 6

Internal factors which contribute to mental health arise from within an individual.
Originating from within an individual, internal factors stem from either a biological or psychological source.

Examples of internal factors which impact an individual’s mental health include:
• Stress response 
• Thought patterns
• Amount of sleep 
• Genetic predisposition 

Example:
One type of internal factor is an individual’s genetic vulnerability which is also known as genetic predisposition. If an individual has a family history of a particular mental health disorder, they may have an increased likelihood of developing this disorder, therefore impacting their mental health.

Question 7

External factors
Define
Example

Answer 7

External factors arise from an individual’s surroundings or outside environment and also contribute to an individual’s mental health.

An individual can experience many fluctuations of their external factors due to the constant changes in their environment. These fluctuations may impact an individual’s position on the mental health continuum, either moving closer towards or further away from being mentally healthy.

An individual’s social relationships are an example of an external factor which can impact mental health.
Examples of external factors which impact an individual’s mental health include:
• Loss of a significant relationship
• Level of education
• Experiencing difficulty within certain environments, such as at work or school

Question 8

High levels of functioning

Answer 8

High levels of functioning are associated with mentally healthy people as they have the ability to independently and effectively carry out every day tasks.

Some examples of high levels of functioning include the ability to:
• Carry out everyday tasks, such as maintaining personal hygiene
• Communicate and maintain relationships with others
• Be productive in achieving tasks
• Set goals and take steps towards achieving them
• Be independent
• Adapt to changes in the environment

If an individual cannot successfully meet the demands of their everyday life, they are not achieving a high level of functioning. Low levels of functioning may lead to a sense of hopelessness, reducing an individual’s self-belief and, in turn, mental health.

Question 9

Social and emotional wellbeing

Answer 9

High levels of social and emotional wellbeing reflect the ability of an individual to create strong relationships, communicate effectively and appropriately regulate their own emotions. This is an important characteristic of a mentally healthy person.

Wellbeing: a state in which an individual is mentally, physically, and socially healthy and secure

Social wellbeing: the ability for an individual to form bonds with others and maintain positive relationships.
Social wellbeing is important, as interacting with others is essential in most environments, such as at school and at home. Strong social wellbeing helps individuals to have a level of confidence and create positive interactions in a
social setting.
Some aspects of strong social wellbeing include:
• Having a strong support network
• Feeling valued by others
• An ability to form new relationships
• Having empathy for others
• An ability to effectively communicate

Emotional wellbeing: the ability for an individual to appropriately control and express their own emotions in an adaptive way, as well as understand the emotions of others.
Individuals with strong emotional wellbeing still experience negative emotions as they are an inevitable part of life. They are mentally healthy due to their ability to regulate these negative emotions and appropriately display them.
Some aspects of strong emotional wellbeing include:
• Being sensitive to the emotions of others
• Having a wide range of emotions
• Expressing emotions at an appropriate time
• Appropriately responding to and coping with stressors

Question 10

Resilience

Answer 10

Resilience involves the ability to effectively adapt to stressors that arise and recover from them. This is a characteristic of a mentally healthy person as it is necessary to cope with the stressors that arise in everyday life.

It is inevitable for stress to occur in everyday life. A mentally healthy person has the ability to overcome these stressors and recover from the challenges presented. This shows a high level of resilience as an individual is able to deal with difficulties presented and continue on with their lives without solely focusing on the cause of stress.
High levels of resilience can reflect and lead to an individual having:
• High self-esteem
• More confidence in carrying out tasks
• Increased flexibility, therefore being able to cope with a range of stressors

Question 11

What does placebo and placebo effect mean?

Answer 11

Placebo: a procedure or substance with no active treatment

Placebo effect: changes to an individual’s mental or physical state as a result of a false belief in the effects of a placebo substance or procedure

Placebo treatments are commonly used in mental health research as they are able to test the effectiveness of new medications.

Question 12

Placebo effect

Why is this relevant for mental health research?

Answer 12

Besides testing the effectiveness of new medications, placebos are also of interest in research on mental health in their own right. This is due to the placebo effect occasionally providing therapeutic benefits itself. This may involve participants experiencing improvements in their mental health purely because of their belief that they are receiving an effective and active treatment. With this in mind, a participant may experience improved mental health after receiving a placebo treatment which they believe to be a valid treatment. These improvements reflect the possible benefits the placebo effect can have on mental health.

Question 13

Why is informed consent particularly important for mental health patients?

Answer 13

Ensuring participants understand the procedures and risks involved in the research they are partaking in, and still willingly agree to participate

This is very important during research into mental health as there are often considerable risks which the participants may encounter. They may become sensitive or distressed during the research, especially if they are experiencing a mental health problem or a mental health disorder. For this reason, the researchers must ensure that every participant has given informed consent by agreeing to participate in mental health research.

Question 14

4P model

Answer 14

A framework to understand the impact of different factors on the development and progression of a mental health disorder

Question 15

Predisposing risk factors

Answer 15

Increase the susceptibility to developing a mental health disorder.

A person’s biological characteristics have the ability to make them more likely to develop a mental health disorder. This can include a family history of mental health disorders, which consequently means that a person has a higher chance of developing a mental health disorder than if there was no history of mental health disorders in their family. Predisposing risk factors such as genetic vulnerability are therefore considered to be outside of the control of the individual who is experiencing them.

Other examples of predisposing risk factors may include:
• Personality traits (e.g. poor self-efficacy)
• Disorganised attachment

Question 16

Precipitating risk factors

Answer 16

A risk factor that increases the susceptibility to and contributes to the occurrence of developing a mental health disorder

For example, if somebody has a genetic predisposition, this does not mean that they are guaranteed to develop a mental health disorder and immediately experience its effects. They are more likely to develop a mental health disorder which could occur at any given stage in their life. In contrast, a precipitating risk factor explicitly causes the mental health disorder.
An example of a precipitating risk factor is the loss of a significant relationship. When somebody separates from their partner it can be extraordinarily distressing. As a result, it can increase the chances of somebody developing a mental health disorder in this state of vulnerability, directly triggering its occurrence.

Other examples of precipitating risk factors may include:
• Poor sleep
• Substance use
• Stress

Question 17

Perpetuating risk factors

Answer 17

A risk factor that inhibits a person’s ability to recover from a mental health disorder

For example, a person could have poor response to medication that was prescribed to them by a doctor or psychiatrist due to genetic factors. As a result, the medication does not work effectively for them, and they are not able to recover from a mental health disorder as planned.

Other examples of perpetuating risk factors may include:
• Rumination
• Impaired reasoning and memory
• The role of stigma as a barrier to accessing treatment

Question 18

Protective factors

Answer 18

A factor that prevents the occurrence or re-occurrence of mental health disorders

Protective factors can prevent people from developing a mental disorder, or prevent the re-occurrence of a mental disorder.
For example, if somebody has adequate sleep, they are more likely to have the biological resources to build resilience and avoid developing a mental health disorder.

Other examples of protective factors may include:
• Adequate diet
• Cognitive behavioural strategies
• Support from family, friends and community

Question 19

Biological risk factors

Answer 19

Factors relating to the body that increase the risk of developing a mental health disorder

• Genetic vulnerability (predisposing)
A person’s genetic predisposition that increases their susceptibility to developing a mental health disorder

• Poor response to medication (perpetuating)
When medication is not effective due to genetic factors

• Poor sleep (precipitating)
Inadequate sleep quality or quantity

• Substance use (precipitating)
Use of either legal or illegal drugs

Question 20

Psychological risk factors

Answer 20

Factors relating to cognitive and affective functioning that increase the risk of developing a mental health disorder

• Rumination (perpetuating)
Repeatedly focusing on negative psychological thoughts and experiences

• Impaired reasoning and memory (precipitating)
Cognitive biases that limit a person’s ability to think about an event in a rational, constructive way and to remember it accurately

• Stress (precipitating)
Psychological and biological process that occurs when an individual does not feel as though they have adequate resources to cope with a stressor

• Poor self efficacy (predisposing)
A person’s confidence in their ability to not complete tasks and meet goals

Question 21

Social risk factors

Answer 21

Factors relating to an individual’s interaction with their external environment and other people that increase the
risk of developing a mental health disorder

• Disorganised attachment (predisposing)
The inconsistent behaviour displayed by an infant towards their main caregiver when they are not provided with consistent and adequate support

• Loss of a significant relationship (precipitating)
Losing a relationship that involved considerable emotional attachment

• Stigma as a barrier (perpetuating)
to accessing treatment
Stigma: a mark of shame or disgrace experienced by an individual for a characteristic that distinguishes them from others

Question 22

Biopsychosocial approach/model

Answer 22

A framework for approaching mental health that suggests that biological, psychological and social factors all interact and contribute to the development of mental illness

Holistic view of mental health

Question 23

Cumulative risk

Answer 23

The significantly increased risk of developing a mental health disorder that occurs when an individual has multiple risk factors present in their lives at the same time.

The effect of experiencing multiple risk factors is greater in impact than experiencing just one risk factor alone, and therefore increases the likelihood of developing mental illness

For example, if an individual has poor self-efficacy, but has an adequate diet, adequate sleep and support from family, friends and their community, they are less likely to develop a mental health disorder than someone else who also has also poor self-efficacy but lacks these protective factors.

Question 24

Stress

Answer 24

A psychological and biological process that occurs when an individual encounters a stressor

Question 25

Phobia

Answer 25

A type of anxiety disorder that is characterised by excessive and disproportionate fear when encountering a particular stimulus

Question 26

Anxiety

Answer 26

A psychological and physiological response that involves feelings of worry and apprehension

Question 27

Similarities and differences between stress, phobia and anxiety

Answer 27

The sympathetic NS becomes dominant in all cases

Stress:
- The response is to a known stimulus
Anxiety:
- The response might be to an unknown stimulus, or generalised
Phobia:
- The response is to a known stimulus

Stress:
- Feelings can be either positive (excitement) or negative (apprehension, nervousness)
Anxiety:
- Feelings of apprehension, unease, worry
Phobia:
- The feeling of fear is predominant

Stress:
- Can be either eustress or distress
Anxiety and Phobia:
- Distress only

Stress:
- Some stress can be adaptive
Anxiety:
- Some anxiety can be adaptive
Phobia:
- Maladaptive

Stress and Anxiety:

• May contribute to the development or progression of mental health disorders
• Phobia:
• Is a diagnosed mental health disorder

Question 28

4 classifications of phobia

Answer 28

• Animal
• Situations (claustrophobia)
• Blood/injections/injuries
• Natural environments (thunder/lightning)

Question 29

Identify and explain the biopsychosocial model and the 4 P’s to explain the development of specific phobia

• Biological

Answer 29

GABA dysfunction:

• an insufficient neural transmission or reception of GABA in the body
• predisposing

The role of the stress response:

• the activation of autonomic NS responses in the face of a stressor
• precipitating factor (increases susceptibility and contributes to the occurrence)

LTP (long-term potentiation):

• the long-lasting and experience-dependent strengthening of synaptic connections
• perpetuating factor (risk inhibiting them from recovering)

Question 30

Identify and explain the biopsychosocial model and the 4 P’s to explain the development of specific phobia

• Psychological

Answer 30

Classical conditioning:

• a model of learning in which organisms learn through the involuntary association of two or more stimuli
• perpetuating

Operant conditioning:

• learning through the association of a behaviour and the consequence it receives
• perpetuating (risk inhibiting them from recovering)

Cognitive bias:

• a predisposition to think about and process information in a certain way
• perpetuating (risk inhibiting them from recovering)

Memory bias:

• a form of cognitive bias caused by inaccuracy or exaggeration in the recall of an event
• perpetuating (risk inhibiting them from recovering)

Catastrophic thinking:

• a kind of cognitive bias in which a stimulus or event is predicted to be far worse than it is likely to be in reality
• perpetuating (risk inhibiting them from recovering)

Question 31

Identify and explain the biopsychosocial model and the 4 P’s to explain the development of specific phobia

• Social

Answer 31

Specific environmental triggers:

• stimuli or experiences in a person’s environment that prompt an extreme stress response
• precipitating (increases susceptibility and contributes to the occurrence)

Stigma around seeking treatment:

• the sense of shame a person might feel about getting professional help
• perpetuating (risk inhibiting them from recovering)

Question 32

Interventions for phobias

Biological

Answer 32

Benzodiazepines
- a type of short-acting anti-anxiety medication that works to reduce anxiety

Use of relaxation techniques

Breathing retraining
- a method used to teach someone breathing control techniques that they can apply when facing their phobic stimulus

Exercise
- the performance of physical activity to improve a person’s health and wellbeing

Question 33

Interventions for phobias

Psychological

Answer 33

Cognitive behavioural therapy (CBT)
- a form of psychotherapy which encourages individuals to substitute unhealthy cognitions and behaviours with more healthy ones

Systematic desensitisation
- a therapy technique used to overcome phobia involving a patient being exposed incrementally to increasingly anxiety-inducing stimuli, combined with the use of relaxation techniques

Question 34

Interventions for phobias

Social

Answer 34

Psychoeducation for families and supporters:

• teaching individuals to better understand mental disorders and how to deal with and treat them
• challenge unrealistic or anxious thoughts
• not encouraging avoidant behaviours

Question 35

‘Evidence based’

Answer 35

A practice that has been rigorously evaluated in experimental evaluations – like randomised controlled trials – and shown to make a positive, statistically significant difference in important outcomes.

Question 36

Resilience

How the biopsychosocial model contributes to resilience
- Biological, psychological and social protective factors

Answer 36

The ability to adapt to the environment and cope when stressors arise in order to return to a functioning state

• Resilience is a psychological protective factor, which prevents the occurrence or re-occurrence of mental health disorders and reduce the impact of stressors

Biological factors:

• those which increase a person’s physiological functioning, making them better equipped to response to and overcome stressors
  e. g. adequate diet and sleep

Psychological factors:

• can increase resilience by equipping a person with cognitive strategies that allow them to response to and overcome stressors
  e. g. cognitive and behavioural strategies

Social factors:

• increase resilience by utilising the way people interact with others and their environment.
  e. g. getting support from family, friends and the community

Question 37

Adequate diet

Adequate sleep

Answer 37

A diet in which a person is provided with the nutrients and energy required to function healthily and effectively

Having enough and the right type of uninterrupted REM and NREM sleep in order to function healthily and effectively

• maintain steady mood
• reduces likelihood of sickness

Question 38

CBT strategies

How is it a protective factor

Answer 38

The techniques of cognitive behavioural therapy used to promote an individual’s psychological resilience

Protective factors promote resilience by supporting a person’s mental and cognitive functioning

Question 39

Support from family and friends

- Specific examples (family, friends, community)

Answer 39

Family
• Unconditional love when you make 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

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

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 like working bees and school fetes
• 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

Question 40

Transtheoretical model

5 Stages:
PCPAM
and relapse

Answer 40

A model which assesses an individual’s readiness to change by looking at the different stages an individual may progress through as they move towards healthier behaviour

1. Pre-contemplation
   - during this stage the individual is unaware that their behaviour is problematic or unhealthy and has no intention to change their behaviour in the next six months
2. Contemplation stage
   - during this stage the individual is aware that their behaviour is problematic
   or unhealthy and is considering taking action within the next
   six months, but has no active commitment to do so
3. Preparation stage
   - during this stage the individual has begun
   to take an active commitment towards changing their behaviour within the next 30 days
4. Action stage
   - during this stage the individual has made distinct behaviour change for less than six months
5. Maintenance stage
   - during this stage the individual has made distinct behaviour change for more than six months and is working to prevent relapse

Relapse
- a setback involving the return to a problem behaviour

Question 41

Transtheoretical model

Stages characteristics

Answer 41

1. Pre-contemplation:
   • The individual is not yet ready for change
   • There is a belief that the behaviour is not problematic
   • Lack of motivation for change
   • Dismissal of concerns from others about the unhealthy behaviour
   • Belief that they are unable to change the behaviour
2. Contemplation:
   • Awareness that the behaviour is problematic
   • Actively thinking about taking steps towards behaviour change within the next six months
   • Not currently taking active steps towards behaviour change
3. Preparation:
   • Taking steps towards behaviour change within the next 30 days
   • The individual has high motivation for change, but may have low confidence for success
4. Action:
   • Active steps have been taken towards the behaviour change
   • High motivation
   • Behaviour change has lasted less than six months
   • Social support is common at this stage
5. Maintenance:
   • The behaviour change has been consistent for at least six months
   • The individual is active in taking measures to avoid relapse

Relapse:
• A temporary setback involving a return to the problem behaviour that is trying to be changed. This can occur at any stage. A relapse may be contrasted with a lapse, which refers to a temporary return to a previous stage rather than a complete and definitive return to the problem behaviour. A lapse may also occur at any stage

Question 42

Limitations of the transtheoretical model

Answer 42

• Time periods are not always consistent as outlined in the model, e.g. a person may experience maintenance after only a few months, rather than the specific period of six months the model outlines
• There is limited research on the psychological processes involved in transitions between stages, as well as what motivates these transitions
• The order of stages in this model has been questioned in terms of their accuracy and ability to fully cover all necessary actions of behaviour change

Question 43

Strengths of the transtheoretical model

Answer 43

• Helps to account for fluctuations and relapses in behaviour change and acknowledges that these can still lead to change in the long term
• Provides a broad account of the processes involved in behaviour change
• Acknowledges that change occurs gradually