Week 11 - Mental Health in Aging

Question 1

This type of therapy focuses on internal biases, challenges distortions in thinking (thoughts, appraisals, and assumptions), and involves structured questioning/development of adaptive thoughts

Answer 1

cognitive behavioral therapy (CBT)

Question 2

Is CBT more effective for minor depression or major depression?

Answer 2

Minor depression!

Question 3

T/F: CBT therapy become less effective as an individual ages

Answer 3

True

Question 4

Early phase of CBT

Answer 4

Identify

Question 5

Middle stage of CBT

Answer 5

challenge

Question 6

Final stage of CBT

Answer 6

review skills and negotiate ending

Question 7

Is CBT sufficient in those with low income status?

Answer 7

No, income is an issue and those who are low-income need more than just CBT to meet basic needs

Question 8

This type of therapy reflects back and integrates the present into a meaningful dialogue

Answer 8

Reminiscence Therapy

Question 9

Life Review Therapy does what?

Answer 9

replaces negative beliefs with positive reflections

Question 10

This type of therapy focuses on the present, identifies and generates solutions to problems

Answer 10

Problem Solving Therapy

Question 11

The core of this therapy focuses on the concepts of loss, attachment, and patterns of early influence

Answer 11

Short-term psychodynamic therapy

Question 12

What is the efficacy of CBT for anxiety?

Answer 12

Moderate effects, not great, for younger adults

Question 13

Is internet-based CBT effective?

Answer 13

Yes! 65% reported improvement up to 12 months follow up; problem, however, is that older adults might not be able to access the internet

Question 14

Benefits of mindfulness include what?

Answer 14

emotional regulation; reduced rumination; stress reduction; boost in working memory; focus; increased cog flexibility; improved relationship satisfaction; helps with overall physical wellbeing

Question 15

What is ACT?

Answer 15

acceptance and commitment therapy; balances acceptance of thoughts and emotions with valued directed behavior change

Question 16

This is the forgotten psychological tool

Answer 16

“forgiveness”; important for older adults as the reflect on their lives and who has hurt them in some way (which has resulted in anger, hopelessness, and despair)

Question 17

Forgiveness can help with:

Answer 17

creating a “positive intention story,” which helps individuals decrease blame and enhance forgiveness

Question 18

Mindfulness meditation may help with:

Answer 18

pain reduction, improved attention, improved sleep, and achieving wellbeing.

Question 19

T or F: Studies found that mindfulness meditation led to decreased salivary cortisol with decreased depression, worry, and anxiety and improved memory

Answer 19

True

Question 20

How does mindfulness work?

Answer 20

Behavioral changes associated with neuroplastic changes in the brain. Must train skill to think positively!

Question 21

What are the 4 ways in which mindfulness works?

Answer 21

(1) Attention Regulation
(2) Body Awareness
(3) Emotion Regulation
(4) Reappraisal, Extinction, and Reconsolidation

Question 22

Mindfulness: what happens to attention regulation?

Answer 22

Attention regulation: experienced meditators have improved executive attention, disregard distractions, improved orienting and alerting, improved conflict monitoring

Particularly useful in treating ADHD, bipolar disorder, post-concussion syndrome, TBI

Question 23

Mindfulness: what happens to body awareness?

Answer 23

Increased awareness of the body’s response to an emotional stimulus might thus lead to greater awareness of one’s own emotional life; in turn, an awareness of one’s emotions is a precondition for being able to regulate those emotions

Relevant to the treatment of eating disorders, substance abuse, and PTSD.

Question 24

Mindfulness: what happens to emotion regulation?

Answer 24

Emotion Regulation: facilitates a return to baseline following reactivity! Increased L Ant. brain activity associated with positive emotions

Relevant to depression, bipolar, PTSD, borderline personality, OCD, phobias, and anxiety disorders

Question 25

True or False: Older adults are not the most depressed age group

Answer 25

True: Happiness rises slightly from ages 18-51 and declines slowly thereafter but this appears very culturally driven. Generally people are happier as they get older; over 70 attend to and savor positivity more than those younger.

Question 26

What causes older adults to suffer from "atypical depression?"

Answer 26

Older adults may suffer from “atypical depression” due to changes in sleep, appetite, weight, energy levels, sexual functioning, and due to diffuse or localized pain

Question 27

What age group is at the greatest risk for any mental illness?

Answer 27

Female (22%), 26-49 (21.2%), 18-25 (19.6%)

Question 28

Who performed better between 200 younger (ages 20-31) vs older (65-80) on 12 different tasks testing perceptual speed, working memory, and episodic memory—repeated over 100 days?

Answer 28

Older staff members were less likely to commit serious errors that are expensive to resolve, observed higher productivity, presented higher consistency in learned strategies to solve the task, were more consistently motivated, and more likely to have a balanced daily routine and stable mood than younger staff members

Question 29

In regards to depression, what is the success rate of antidepressants and CBT? Placebo?

Answer 29

Antidepressants/CBT: 65% success rate, Placebo: 45-55% success rate

Question 30

What causes depression?

Answer 30

Best guess of behavioral geneticists: 50% genetic set-point, 10% circumstances, 40% what you think and do! We have a lot of power over our mood/state.

Question 31

What are the symptoms of depression?

Answer 31

Decreased engagement with increasing avoidance, comorbidity with physical illness masks symptoms, decline in cognitive/executive function

Question 32

What are the occupational performance deficits of depression?

Answer 32

Diminished pleasure, loss of energy, decreased attention to ADL’s, withdrawal and isolation, poor sleep, eating too much or too little, poor executive function

Question 33

True or False: The highest completed suicide rate is among older males

Answer 33

True

Question 34

What is delirium?

Answer 34

Disturbance in consciousness, attention, cognition, and perception. Mostly an issue in medical/surgical settings, rare in the community. Mostly treated by minimizing sedating meds.

Question 35

What symptoms are more common with older adults with depression?

Answer 35

In older adults more likely to have symptoms related to poor sleep, decreased energy, psychomotor retardation, decreased interest in living.

Question 36

Less than one third of people taking antidepressant meds have seen a mental health professional in the last year. Why?

Answer 36

Professionals don't want old clients. There is virtually no research specific to this older population.

Question 37

What is Interpersonal Therapy and how effective is it in relation to depression?

Answer 37

- Focuses on interpersonal events and roles - Effective, though no better than CBT or other types of psychotherapy - Focuses on one or two of these four areas: 1) grief and bereavement, 2) role transitions, 3) role disputes, 4) interpersonal deficits.

Question 38

Mindfulness: what happens to reappraisal, extinction, and reconsolodation?

Answer 38

Reappraisal: adaptive process through which stressful events are reconstrued as beneficial, meaningful, or benign. Extinction: does not erase the initial association between conditioned and unconditioned stimuli but is thought to form a new memory trace Reconsolidation: strategies allow the mind and neural pathways to be changed, allowing for a more adaptive response to stress

Question 39

What does practicing nonreactivity through mindfulness meditation lead to?

Answer 39

nonreactivity leads to unlearning of previous connections (extinction and reconsolidation) and thereby to liberation from being bound to habitual emotional reactions

Question 40

What is self kindness?

Answer 40

being kind as opposed to being self critical

Question 41

What is common humanity?

Answer 41

seeing one’s experience as indicative of the larger experience of being human

Question 42

What is mindfulness?

Answer 42

maintaining one’s thoughts in balanced | awareness rather than over-identifying with them

Question 43

What are 8 things you can do to enhance your brain?

Answer 43

* Smile * Stay intellectually active * Consciously relax * Yawn * Meditate * Aerobic exercise * Dialogue with others * Faith