Unit 4 Outcome 2. 8/9/10 Flashcards
Mental Wellbeing
is an individual’s current state of mind, including their ability to think, process information, and regulate emotions.
levels of functioning
levels of functioning refer to the degree to which an individual can complete day-to-day tasks in an independent and effective manner.
Characteristics of High levels of functioning
carry out basic everyday tasks, such as maintaining personal hygiene and dressing appropriately
* be productive in completing daily tasks
* set goals and take steps towards
achieving them
* be independent
* adapt to changes in the environment.
Characteristics of Low levels of functioning
struggle to carry out basic tasks, such as maintaining personal hygiene and dressing appropriately
* feel uncharacteristically lethargic or tired and thus be unproductive in achieving tasks
* lack direction or be able to set goals in life
* be unable to cope with changes in the environment.
levels of functioning effect
prevents people from becoming easily overwhelmed and increases an individual’s sense of capability and control in their lives.
Low levels of functioning may lead to a sense of hopelessness, reducing an individual’s self-belief and,
in turn, mental wellbeing.
Resilience
refers to the ability to cope with and manage change and uncertainty.
High levels of resilience characteristics
- seek solutions to problems
- use appropriate coping strategies
- be flexible in changing circumstances
- be optimistic and hopeful.
Low levels of resilience characteristics
- 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.
A high level of resilience is a feature of an overall positive state of mental wellbeing because it can be a result of, or lead to, 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.
Being resilient does not mean…
Being resilient does not mean that your life is without difficulty or distress, or that you are always happy. Rather, high levels of resilience lead to mental wellbeing as you are able to respond effectively to stressors, overcome them, or adapt to them.
Interestingly, resilience is something that can be taught and developed over time and often results from seeking appropriate social support in times of stress.
Social Wellbenig
involves the ability for an individual to form and maintain meaningful bonds with others, and adapt to different social situations
Emotional Wellbeing
involves 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.
High levels of social wellbeing
have a strong support network
* be able to form and maintain meaningful
relationships
* be able to effectively communicate with others.
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 high levels of emotional wellbeing can regulate
- can regulate their own emotions well, expressing positive and negative emotions at suitable times.
- can also display empathy and effectively understand and respond to other people’s emotions.
- still experience negative emotions as they are an inevitable part of life.
High levels of emotional wellbeing
- be aware of their own and others’ current emotional state
- experience a wide range of emotions
- express emotions at appropriate times.
Low levels of emotional wellbeing
- 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
SEWB + multidimensional + holistic
Social and emotional wellbeing (SEWB), which is a holistic and multidimensional framework of social and emotional wellbeing that comprises of elements of being, and therefore wellbeing, for Aboriginal and Torres Strait Islander peoples.
multidimensional: made up of different components/domains of connection (body, mind and emotions, family and kinship, community, culture, Country, spirituality and ancestors) that are central to wellbeing
holistic: reflects an approach to wellbeing that considers the whole person, including their mental, physical, spiritual, emotional, cultural and social needs.
It is based on a holistic, multidimensional view of health that recognises their connection to Country, culture, spirituality, ancestry, family and community, which are important to their people and impact on their wellbeing.
Connection to body
Connecting to the physical body and health in order to participate fully in all aspects of life.
Eg
* Maintaining a healthy weight.
* Access to good nutrition.
* Managing illness and disability.
Connection to mind and emotions
Ability to effectively manage thoughts and feelings.
* Maintaining self-esteem.
* Connecting to values and motivation.
* Maintaining a strong identity.
Connection to family and kinship
Connection to the immediate and wider family group and community.
* Spending time within family groups promotes a feeling of connection and therefore wellbeing.
* Caring for the ill is the responsibility of all
Connection to community
Connection to wider social systems, providing individuals and families the ability to connect with and support each other.
- Community services and support networks.
- The ability to maintain community connections plays an integral role in maintaining the wellbeing of individuals
Connection to Culture
A strong sense of identity, values, tradition, and connection between the past, present, and future that drives behaviour and beliefs.
- Elders passing on information and tradition to future generations.
- Speaking local languages.
- Attending cultural events.
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.
* 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.
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
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.
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.
Social Determinants
The circumstances in which people grow, live, and work, and the systems put in place to deal with illness
Socioeconomic status (level of wealth)
* The impact of poverty * Unemployment
* Racial discrimination
Historical Determinants
The ongoing influence of events, policies, and trauma on groups of people.
* Colonisation and its legacy
* The impact of past government policies
Political Determinants
Political policies that shape the process of distributing resources and power to individuals and communities, and create or reinforce social and health inequalities
*Unresolved issues of land
* Control of local resources
* The rights of self-determination and sovereignty
Mental Wellbeing Continuum
refers to a tool used to track fluctuating mental wellbeing, ranging from high levels of mental wellbeing to low levels of mental wellbeing.
Mental Wellbeing is a dynamic
As mental wellbeing is a dynamic state, an individual’s placement on the continuum is not fixed and can shift over time. This means that someone with a diagnosed mental health disorder, placed at low levels of mental wellbeing on the continuum, may not always experience distress. If their condition is well managed with adequate support, they may move up the continuum to become categorised as having moderate levels of mental wellbeing.
High levels of mental wellbeing
- able to function independently within their everyday life
- able to cope with every day demands without showing an excessive level of distress and dysfunction
- still may experience stress, sadness, and anger, but have ability to cope with these experiences, regulate emotions, and express them appropriately.
Middle of the continuum
- 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.
causes and impacts of being in the middle of the continuum tend to be less severe and more temporary in nature compared to low levels.
Low levels of Mental Wellbeing
shows high levels of distress
* is unable to independently complete tasks and meet the demands of their environment
* is impacted for an extended period of time (more than two weeks)
* may be diagnosed by a mental health professional and may be treated through psychotherapy or medication.
Internal and External factors
Internal factors are factors that arise from within the individual.
External factors are factors that arise from an individual’s environment.
These factors interact to influence a person’s mental wellbeing in two ways.
*They can contribute to the development or progression of low levels of mental wellbeing.
* They can protect an individual from the development or progression of low levels of wellbeing, instead maintaining high levels of mental wellbeing.
Internal Factors
examples of types
how can this maintain high levels
lead to low levels?
types
* Stress response
* Thought patterns
* Genetic predisposition
maintain high levels
If a person has naturally optimistic thought patterns, they may be more likely to view difficult situations positively and thus protect their mental wellbeing.
low levels?
If a person has a genetic predisposition to a mental health disorder, they may be more likely to develop one, leading to a greater likelihood of having low levels of mental wellbeing.
External Factors
examples of types
how can this maintain high levels
lead to low levels?
types
* Loss of a significant relationship
* Experiencing difficulty within certain environments
* Access to support services, such as medical and psychological treatment
maintain high levels
support systems, like friends, family, or professional support, will help maintain high levels of MW, even in difficult circumstances.
low levels?
loss of a significant relationship can negatively impact mental wellbeing if not adequately addressed, which involves low levels of mental wellbeing.
Stress
a psychological and physiological experience that occurs when an individual encounters something of significance that demands their attention and/or efforts to cope.
Characteristics of stress
- stress is a normal part of life, and is not necessarily a sign of low levels of mental wellbeing.
- distress occurs, however, when an individual does not feel as though they have adequate resources to cope with a stressor, it can lower an individual’s level of mental wellbeing.
- stress is usually in response to a known cause, which differentiates it from anxiety.
anxiety
is a psychological and physiological response that involves feelings of worry and apprehension about a perceived threat.
Characteristics of anxiety
While stress can involve both positive (eustress) and negative (distress) feelings, anxiety typically only involves negative feelings (distress).
* Anxiety is broader than stress and may be due to an unknown stimulus.
* Anxiety is usually future-oriented, meaning that it involves worrying about events that may happen in the future.
Both stress and anxiety are on the moderate to high part of the mental wellbeing continuum. They are similar because:
- people will experience both stress and anxiety from time to time, expected part of daily life.
- usually don’t interrupt daily functioning and are not always a sign of low mental wellbeing.
- some stress and anxiety can be adaptive for functioning as they can motivate people to take action.
Specific Phobiae
is a type of diagnosable anxiety disorder that is categorised by excessive and disproportionate fear when encountering or anticipating the encounter of a particular stimulus
Characteristics of specific phobia
- an individual going to great lengths to avoid their phobic stimulus
- significant disruption to an individual’s daily functioning either at work, home, etc.
- low levels of mental wellbeing when encountering or attempting to avoid the phobic stimulus.
- maladaptive
the sympathetic nervous system is dominant when exposed to their phobic stimulus, which can result in physiological stress responses including:
- increased heart rate
- rapid breathing
- increased perspiration
- dilated pupils.
Biopsychosocial approach
is a holistic, interdisciplinary framework for understanding the human experience in terms of the influence of biological, psychological, and social factors.
s a way of describing and explaining how biological, psychological and social factors combine and interact to influence a person’s mental health and wellbeing.
biological factors
are internal, genetic, and/or physiologically based factors.
psychological factors
are internal factors relating to an individual’s mental processes, including their cognition, affect, thoughts, beliefs, and attitudes.
social factors
are external factors relating to an individual’s interactions with others and their external environment, including their relationships and community involvement.
Biological factor GABA dysfunction
GABA
refers to the insufficient neural transmission or reception of GABA in the body needed to regulate neural transmissions, specifically, counterbalance the excitatory activity of glutamate
lower levels of GABA are common in people with phobias and other anxiety disorders
The lack of inhibitory neural transmission in the body leads to over-excitation at the synapses, and this decreased ability to regulate neural firing can lead to feelings of anxiety.
Low GABA can create a vulnerability to anxiety and a more easily triggered fight-flight-freeze response than someone with adequate GABA levels.
- recurrent stress responses to specific stimuli can lead to the development of a phobia.
Long term potentiation
is the long-lasting and experience-dependent strengthening of synaptic connections that are regularly coactivated.
long term potentiation process
strengthening the association between neural signals involved in perceiving a stimulus and neural signals involved in activating the fear response.
The repeated activation of both these neural signals together can lead to the development of a phobia, as the stress response is associated with and activated at the same time as the perception of a certain phobic stimulus.
The more this occurs, the stronger the association becomes, and the stronger the phobia becomes.
Decreases likelihood of fear response can be forgotten
Increases efficiency in transferring fear information along pathways.
Classical conditioning precipitating factors
Precipitating factors are factors that increase the susceptibility to and contribute to the occurrence of developing a specific phobia.
Therefore, classical conditioning can precipitate specific phobia as phobias can be learned, and developed, through classical conditioning.
NS = phobic stimulus; associated with threat danger or unpleasant event (UCS)
CR = phobic response
without repeated association cc specific phobia
suggested classical conditioning can precipitate a specific phobia without repeated pairings of the NS and UCS
. If the experience is highly traumatic, an individual can be conditioned to experience a fear response after one pairing of the neutral stimulus and unconditioned stimulus.
Operant conditioning perpetuating factors
Perpetuating factors are factors that inhibit a person’s ability to recover from a specific phobia. In this way, operant conditioning perpetuates phobias by preventing an individual from overcoming them.
operant conditioning process
- an individual with a phobia will generally avoid contact with their phobic stimulus at all costs.
- by avoiding confrontation with the phobic stimulus, a person is negatively reinforced through this avoidance in not having to deal with their fear response.
- over time, this reinforcement strengthens
or maintains the phobic response, making avoidance behaviours more likely to be repeated and preventing recovery through this cycle.
Cognitive bias
is a predisposition to think about and process information in a certain way which may cause errors in judgements and faulty decision making.
Memory Bias
present knowledge, beliefs and feelings distort the recollection of previous experiences. Negative or threatening information about the phobic stimulus is recalled rather than positive or neutral info. Memories of phobic stimulus are reconstructed as more frightening then they actually are.
more likely to recall negative memories of the phobic sitmulus
Catastrophic Thinking
type of cognitive bias in which a stimulus or event is predicted to be far worse than it actually is. Often imagine the worst-case scenario possible when imagining an interaction with their phobic stimulus.
contributes to phobia, making stimuli seem worthy of extreme fear and anxiety. Feel helpless and underestimate capacity to cope.
Specific Environmental Triggers
refer to stimuli or experiences in a person’s environment that evoke an extreme stress response, leading to the development of a phobia.
form an emotional memory/negative bias towards phobic sitmulus
types of environmental triggers
- direct confrontation with a traumatic stimulus or event, e.g. being bitten by a snake.
- observing another person having a direct confrontation with a traumatic stimulus or event
- learning about a potentially dangerous or traumatic stimulus or event indirectly,
Stigma
refers to the feeling of shame or disgrace experienced by an individual for a characteristic that differentiates them from others.
Stigma around seeking treatment
stigma around seeking treatment refers to the sense of shame a person might feel about getting professional help for their phobia.
They might feel as though their phobia is too embarrassing or insignificant to seek professional help, or as though they are unusual and isolated from society in some way for doing so.
Benzodiazepines
are a type of medication that depresses central nervous system activity and is often used as a short-acting anti-anxiety medication.
How do benzodiazepines work
Benzodiazepines are considered to be agonists, which are a type of drug that imitates neurotransmitters and works to initiate a neural response (excitatory or inhibitory) when it binds to the receptor sites of a neuron.
individuals with GABA dysfunction will experience an over- excitation of neural pathways.
As an agonist, benzodiazepines bind to GABA receptor sites and mimic the effects of GABA to increase its inhibitory response.
By inducing inhibitory responses, the rapid excitatory communication between neurons in the fear response is reduced, relieving the anxiety it causes and leading to the relaxation of muscles.
Breathing Retraining
is a method used to teach breathing control techniques that may reduce physiological arousal.
why is breathing retraining needed
When someone with specific phobia is facing their phobic stimulus, they often experience fast, shallow breathing as their sympathetic nervous system becomes dominant. lead to hyperventilation and other sympathetic NS responses = increased anxiety.
This restores the amount of oxygen in the body to an optimal level to help the parasympathetic nervous system become dominant, in turn decreasing the dominance of the sympathetic nervous system and reducing anxiety.
process of breathing retraining
- slow and deep inhalations, followed by slow and controlled exhalations
- counting slowly when breathing in, and when breathing out
- breathing slowly in through the nose, and focusing on breathing out slowly from the
diaphragm.
Cognitive Behavioural Therapy
is a form of psychotherapy that encourages individuals
to substitute dysfunctional cognitions and behaviours with more adaptive ones.
Cognitive Component
– identifying negative thoughts and feelings (cognitions) about the issue.
– replacing these negative thoughts and feelings with more positive ones.
questioning whether fears are just hypotheses rather than facts, and thinking about the likelihood of them happening
Behavioural Component
– identifying negative behaviours relating to the issue.
– developing and maintaining more positive behaviours relating to the issue.
Cognitions n Behaviours that may contribute to phobia
cognition:
Memory bias
* Catastrophic thinking
* Embarrassment
Behaviour:
* Avoidance behaviours in which a person avoids their phobic stimulus and anything related to it at all costs
* Not seeking help
* Avoiding social activities that may expose a person to their phobia
Systemic Desensitization
is 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.
Systemic desensitization process
1) Relaxation techniques are taught that can be applied to reduce physiological arousal like breathing retraining which is slow controlled breathing (IN THROUGH THE NOSE AND OUT THROUGH THE MOUTH)
2) The development of a fear hierarchy, or a list of feared objects or situations ranked from least to most anxiety producing.
3) Systematic, graduated pairing of items from least to most anxiety inducing in the hierarchy with relaxation response until fear response if eliminated at each level.
4) Continuation of this process until the most fear inducing stimulus produces no fear/phobic response
Psychoeducation
involves teaching families and supporters of individuals with mental health disorders how to better understand, deal with, and treat their disorder.
increases understanding of symptoms, treatment options, services available and recovery patterns enables individuals to cope more effectively and live more fulfilled lives.
2 important components of psychoeducation
- challenging unrealistic or anxious thoughts of the individual, and
- not encouraging avoidance behaviours.
- challenging unrealistic or anxious thoughts of the individual
Family and supporters are encouraged to actively challenge these thoughts in order to help a person with a specific phobia to understand that some cognitive components of their fears are potentially unfounded and irrational. This should be done in a supportive, non-judgemental fashion.
not encouraging avoidance behaviours
families and supporters are taught that they should not encourage avoidance behaviours, as they do not solve and only perpetuate the phobic anxiety.
exposure provides opportunity to learn how to cope with fears
comforting rather than challenging may unintentionally encourage or reinforce avoidance
behaviour
Protective factors
are influences that enable an individual to promote and maintain high levels of mental wellbeing.
- reducing the risk of low levels of mental wellbeing or developing a mental health disorder
- increasing the likelihood of high levels of mental wellbeing.
biological protective factors
refer to influences that stem from an individual’s brain and/or body that can maintain or promote mental wellbeing.
Adequate hydration and nutrition
is when the type and amount of food and drink that an individual consumes meet their physical needs. This can include ensuring that an individual has sufficient water, carbohydrate, protein, fat, vitamin, and mineral intake.
Hydration
it is recommended that individuals drink 2–3 litres of water per day for optimal physiological functioning. (dependent on individual characteristics)
Research has suggested that drinking enough water is beneficial for mental wellbeing
Sleep
adequate sleep essentially involves
regularly having the right amount of sleep time and enough good quality sleep to awaken feeling
refreshed and rested at most times
Good sleep is likely to reduce the likelihood of mental health disorders and promote mental wellbeing, therefore acting as a protective factor.
deprivation higher chance of devloping phobia
more calm when confronting phobia
Cognitive behavioural strategies
are techniques that utilise traits of cognitive behavioural therapy, particularly recognising and changing dysfunctional thought and behavioural patterns.
Cognitive restructuring is the process of learning to identify, challenge, and modify or replace negative, irrational thoughts with more reasonable and helpful ways of thinking (maladaptive)
Cognitive distortions - magnification (of mistakes) and fortune telling (predict bad things with no proof)
Mindfulness meditation
practice of meditation in which an individual focuses on their present experience to promote feelings of calm and peace.
Mindfulness meditation is a specific type of meditation that encourages an individual to pay attention to the present moment, including their current feelings, thoughts, and surroundings
mindfulness meditation can
- improve emotional reactivity
- reduce the likelihood of rumination (repeatedly considering negative thoughts)
- reduce stress
- improve memory
psychological protective factors
refer to influences that relate to mental processes that can maintain and promote mental wellbeing.
social protective factors
refer to influences that exist in an individual’s social environment that can maintain and promote mental wellbeing.
support
refers to genuine and effective assistance provided by family, friends, and community.
Support can provide comfort and reassurance and can encourage individuals to develop different strategies to promote their mental wellbeing.
ensure that support being provided
- genuinely aims to promote mental wellbeing
- is focused on creating an environment that is likely to improve mental wellbeing
- uses legitimate and effective advice.
examples of support family friends community
family:
* Unconditional love when an individual makes a mistake
* Encouragement to change and avoid unhealthy behaviours
friends:
* Reduction of stress and an increase in happiness
* A sense of belonging
community:
* A sense of belonging and connectedness to a wider social circle
* Opportunities for interaction and bonding,
Determinants of Wellbeing
Cultural Determinants
refer to factors that influence wellbeing on individual and community levels.
Cultural determinants of mental wellbeing are protective factors that help maintain strong connections to culture, strengthen cultural identity, enhance resilience and contribute to the maintenance of good mental wellbeing like self-determination and cultural continuity.
Integral to the maintenance of mental wellbeing for Aboriginal and Torres Straight Islanders
Culture
culture can be understood as encompassing a strong sense of identity, values, tradition, and connection between the past, present, and future that drives behaviour and beliefs.
Cultural continuity
which refers to the passing down and active practice of cultural knowledge, traditions, and values from generation to generation.
can be achieved through a variety of cultural practices, including engaging with arts, crafts, music, dance, theatre, writing, storytelling, languages, food, and so much more.
cultural continuity destroyed and why important
Cultural continuity can be disrupted or destroyed if cultural practices are not allowed to continue.
vital cultural determinant for the re-establishment and maintenance of wellbeing in Aboriginal and Torres Strait Islander communities, and Indigenous populations worldwide, as it enables communities to heal and form strong identities.
self determination
all nations have the right to self-determination, which refers to the rights of all peoples to pursue freely their economic, social, and cultural development without outside interference.
self determination how achieve
- Aboriginal community-controlled organisations.
- established partnerships between communities, governments, and non-government organisations, which is any not-for-profit organisation that exists to address a political or social issue.
- constitutional recognition which empower Aboriginal and Torres Strait Islander peoples to determine their own futures
self determination effect on mental wellbeing
Autonomy and independence are very important aspects of wellbeing for individuals because it enables individuals to feel in control over their own lives and live on their own terms.
integral factor for the maintenance of wellbeing as it enables communities to protect what is most important to them on a wider scale.
Self-determination requires that First Nations people are involved in ‘every layer of decision making’ including decisions that impact communities, states, and the country as a whole.
‘evidence-based
intervention’
intervention: a treatment that has been found to be effective on the basis of valid, peer reviewed, reliable research studies
advantages of bendodiazepines
a short-acting variant with rapid onset may be used intermittently to cope with an occasional, unavoidable
encounter with a phobic stimulus
tend to be highly effective in minimising symptoms
- tend to have very few side effects
disadvantage of bendodiazepines
can promote dependency over the long term, highly addictive
reduced alertness, drowsiness, slower reaction times
- only treats symptoms, not underlying causes
benefits of breathing retraining
learning how to maintain correct breathing when experiencing or anticipating a phobic
stimulus, reduce anxiety-related symptoms
enhanced ability to remain calm when facing a phobic stimulus and increased feelings of control over the anxiety or fear.
GABA
the primary inhibitory neurotransmitter in the central
nervous system, making postsynaptic neurons less likely to fire
Why is benzodiazepine used in conjunction with other interventions?
the drugs treat symptoms, not the underlying cause of anxiety i.e. the specific phobia
potentially addictive e.g. induce tolerance, dependence, withdrawal reactions
do not teach any non-drug dependent coping skills for the phobia
