wk 3 MH Flashcards
General definition:
(Psychological) trauma
a (‘traumatised’): A
general term referring to an emotional (&
physiological) response to an intensively
distressing event/s, which can have lasting
mental, emotional, physical and social
impacts
(Potentially) traumatising experiences are more likely to develop into mental health difficulties when traumatic experiences are:
- Repeated/multiple or prolonged; when ”escape” is difficult or impossible
- Interpersonal (they involve people close to the person or meaningful others)
- Happen at critical developmental stages (childhood, adolescence and ‘life transitions’)
- Stress proliferation theory/effects (Pearlin, 1981; LeBlanc et al., 2015)
- A stressor/set of stressors expand or develop within and beyond a situation
- Result in new stressors (that were not originally present)
- Thus, early stressors in life may increase risk to mental health difficulties via the proliferation of further stressors
- Mothers’ own adverse childhood experiences were associated with child mental health difficulties at 5 years, mediated by maternal depression and attachment difficulties (anxiety/avoidance) (Cooke et al., 2019) – Suggests that …
Suggests that trauma can have indirect intergenerational effects on mental health
On average, people exposed to childhood adversities
are ___ x more likely to develop psychosis (Varese et al., 2012)
Up to a third of cases of psychosis could be attributable
to the impact of childhood adversities (Varese et al., 2012)
Those exposed to 5 types of childhood trauma: __x
more likely to have experienced psychosis (Shevlin et al.,
2007)
3x
53 x
cognitive and emotional effect of adverse life experiences
- Sense of threat
- emotional dysregulation (struggle to find balance)
- Negative belief about self, others, world
- Maladaptive thinking styles (rumimnation suppression)
adverse life experiences affecting physiological
-stress effects on neuroendocrine system (eg HPA axis)
-Long lasting neurobiological changes e.g: hightened stress sensitivity
how do adverse life experiences effect behaviour
-Health harming beh as a way of coping e.g: alc, drug, self harm)
-Other behaviours as ways of coping
adverse life experiences affecting social
- difficulties in relationships and trusting others (directly and indirectly due to the other effect)
Research
limitations
on ACES
(adverse childhood experiences)
-Most use retrospective data ( may not report, may have limited recall)
-Life event Counts are limited as not all ACEs are equal
-ACES do not occour randomly, predispositions
-focus on ACES means relatively little is known about hat kind of stressors impact MH the most
-
Merrick et al.’s (2017) Californian study
(N = 7465) found a dose-response
(graded) relationship between number
of ACEs and _______ affect
depressed
Estimated % who develop PTSD following…
Severe beating / physical assault
___._%
Stabbing or shooting
__._%
31.9
15.4%
estimated % who had depression after loosing a spouse later in life =
13%
Most of us experience have experience of 1+ ‘potentially
traumatising’ life experiences (PTEs):
____% based on combined samples from 24 countries using the
World Mental Health Survey (N = >68k)
* And 30.5% had 4+ PTEs (Benjet et al., 2015)of older US adults (mean 60 years) (Ogle et al., 2013)
90
___% based on combined samples from 24 countries using the
World Mental Health Survey (N = >68k)
* And ___% had 4+ PTEs (Benjet et al., 2015)
70%
30.5
Individuals with depression are at _._x - _._x as likely to have
experienced a major stressful life event before the first onset of
depression (Kendler et al., 2000; Slavich & Irwin, 2014).
2.5x
9.4x
Developmental trauma:
Childhood trauma (usually repeated/prolonged) characterised by various forms of dysregulation (affective, behavioural, attentional, physiological), but often does not fit the PTSD criteria based on the defined stressor(s) (low or no recollection); neither are there some PTSD symptoms; e.g. flashbacks (Van der Kolk, 2005)
High prevalence of at least 1 ACE: ___% British adults;___% Korean adults, __% Swedish adults
* __% of UK adults have experienced 4+ ACEs
47%
50
25
8
Much higher rates of 1+ ACEs in Low and Middle Income Countries (LMIC)
* E.g. ___/__% young Malawian men/women, >__% Brazilian adolescents, __% in Philippines and China
90/77%
80
75
Regarding types of ACE, ______ abuse may be particularly
destructive to mental health.
emotional
Meta-analysis of 97 studies by Palmer-Klaus et al. (2015) found:
- Bipolar disorder: __ times more likely than non-clinical controls to report childhood emotional abuse
- Borderline personality disorder: __x more likely than controls to report childhood adversities;
__x more likely to report childhood emotional abuse
4
14x
38x
Merrick et al. (2017): The strongest effect of any single ACE on outcomes measured was emotional abuse on ______ _______ (5.6 times increased risk)
attempted suicide
The way society is structured contributes to mental health difficulties through:
social inequality e.g.
Social inequality
* Poverty (or socioeconomic disadvantage) * Discrimination (e.g. racism, transphobia, homophobia)
Discrimination
Unfair treatment or negative attitudes towards categories of people (based on age, gender, race/ethnicity, religion, disability, sexual orientation etc.)*
Not always overt; often ‘subtle’ but damaging forms of singling out members (e.g. limiting access to social resources)
Across Europe (N = 40k), those belonging to more _______ ‘categories’ have more depressive symptoms
minoritised
- Effect stronger in Eastern & Southern European countries; Alvarez-Galvez &
Ethnic minorities have a higher risk of _____
(24 studies; Pearce et al., 2019)* Not explained by immigration
psychosis
Young homeless people who report more discrimination report more _______ distress/suicidal ideation (Narendorf et al., 2022)*
Reasons for discrimination include housing status, sexual orientation, juvenile justice involvement
psychological
Extent of within-country wealth and______ _______correlates with the incidence of
many mental health issues
social
inequality
Levels of psychotic disorders are____ x
higher in people in the ____ _____
households compared to the highest.
9 times
lowest fifth income
Slight ‘U-curve’ supports a small resilience effect:
low levels of adverse events more protective than no adverse life events
A d_____-______ relationship: As adverse events accumulated (especially 9+ events), emotional distress increased
dose-response
How can Goal Orientation
buffer or counteract the impact of life adversities (i.e. resilience / protective factors)
which goals should you set
confidence, academic aspiration, life satisfaction
How can Social support buffer or counteract the impact of life adversities (i.e. resilience / protective factors)
- Having the support of an adult,
- family cohesion,
- perceived emotional support,
- access to social support,
- social resources
How can cognition and cognitive strategies buffer or counteract the impact of life adversities (i.e. resilience / protective factors)
Cognition and cognitive strategies
Greater perceived self efficacy/control
less negative affectivity
less rumination
most important positive buffering effects to adverse life experiences in Older adults=
in younger people=
older: Life satisfaction and social support important;
young people: goals, attachment & IQ
most important positive buffering effects to adverse life experiences in marginalised groups
the protective role of community / neighbourhood support is important
Trauma-informed care encourages mental health
professionals to assume t…
that all individuals who access
mental health services might have experienced important
adverse life events
info
Therapeutic relationship as source of social and emotional support
Therapist as a model of self-compassionTherapist to encourage adaptive coping and health-promoting behaviours
Therapist to help retrain cognitions
info
Therapeutic relationship as source of social and emotional support
Therapist as a model of self-compassionTherapist to encourage adaptive coping and health-promoting behaviours
Therapist to help retrain cognitions
When working with individuals in distress, provision of ‘______’
experience and ______ factors help to boost psychological resilience and prevent, reduce and alleviate mental health difficulties
corrective
protective
