PSYCH EXAM REVISION

Mentally healthy characteristics

• High level of functioning

• Form positive relationships with others (high level of social wellbeing)

• Manage feelings and emotions (high level of emotional wellbeing)

• Cope with day-to-day stresses; that is, cope with and manage change and uncertainty

• Think logically and problem solve • Have reasonable level of confidence in their abilities and self-esteem

Mental health problems characteristics

• Have increased or decreased sleep and appetite

• Experience loss of energy and motivation

• Have difficulty concentrating

• Have difficulty focusing/completing work or study tasks

• Experience irritability

• Become withdrawn

Mental disorders characteristics

• Have reduced level of day-to-day functioning

• Have reduced ability to cope with and manage change and uncertainty

• Have impaired ability to engage in social relationships

• Experience significant changes in thoughts, feelings, behaviours or lack of interest (apathy)

• Show serious or prolonged changes in typical character

• Have impaired ability to function independently, such as taking care of oneself at home

level of functioning

How well an individual independently and effectively performs or ‘functions’ in their environment, meeting the ordinary demands of everyday life.

-can be represented on a continuum

Level of functioning tends to correspond with how well a person is meeting the challenges of living across a range of areas: DILECS

• daily living skills e.g. self-care, personal hygiene, dressing, eating, household responsibilities, travel/commute safely

• interpersonal relationships e.g. interact with and get along with other people

• leisure/recreational activities e.g. participation in extracurricular activities at school, hobbies/interests/structured or unstructured activities in ‘free’ time outside school/work, engagement in sports or community activities.

• emotions e.g. self-regulation of a range of emotions, dealing with positive and negative emotions, keeping effects of daily worries, hassles and other stressors under control

• cognitive skills e.g. learning and applying knowledge, understanding and communicating, logical and clear thinking, planning and decision-making

• school and work/occupational settings e.g. productive and achieving goals

high level of functioning -> (what behaviour and what does it allow the individual to do)

Adaptive behaviour -> enables the individual to adjust to the environment appropriately and effectively.

Low level of functioning ->(what behaviour and what does it allow the individual to do)

maladaptive behaviour (dysfunctional )->  detrimental, counterproductive or otherwise interferes with the individual’s ability to successfully adjust to the environment and fulfil their typical roles in society.

Resilience (‘Bouncing back’ from adversity or difficult experiences)

The ability to successfully cope with and manage/adapt to change and uncertainty or stressors arsing in order to return to a functioning state.

mentally healthy person tends to be

resilient -> more likely to perceive a major life stressor as an opportunity to excel because they have the resources to cope.

Mentally unwell person tends to be

not resilient -> more likely to feel significantly challenged or even overwhelmed

Some characteristics that enable someone to ‘bounce back’

• a strong belief in their abilities to accomplish tasks and succeed (i.e. high self-efficacy)

• high self-esteem

• approaching adversity with a sense of optimism, opportunity and hope

• being adaptable and flexible

• being organised

• having problem-solving skills

• having the ability to make realistic plans and carry them out.

Social and Emotional Wellbeing (SEWB)

term is used by Aboriginal and Torres Strait Islander people to describe the physical, social, emotional, spiritual and cultural wellbeing of a person

SEWB is holistic and multidimensional meaning

->  focuses on the physical, social, emotional, spiritual and cultural wellbeing of the individual, their family and the entire community to which they belong, thereby bringing about the total wellbeing of their community.

These elements are interrelated and overlap.

health is - contains - interconnected domains - over the lifespan it -

interconnected and multifaceted

contain 7 interconnected domains

changes over the lifespan

determinants types

social, historical, cultural, political

Determinants influence -

they influence domains

7 domains

body, mind and emotions, family and kinship, community, culture, country, spirituality and ancestors

Connection to body

Physical health – feeling strong and healthy and able to physically participate as fully as possible in life.

Connection to body risk factors

• Chronic and communicable diseases; poor diet; smoking

Connection to body protective factors

Access to good healthy food; exercise; access to culturally safe, culturally competent and effective health services and professionals.

Connection to mind and emotions

Mental health – ability to manage thoughts and feelings.

Connection to mind and emotions risk factors

Developmental/cognitive impairments and disability; racism; mental illness; unemployment; trauma including childhood trauma.

Connection to mind and emotions protective factors

Education; agency (assertiveness, confidence and control over life); strong identity.

Connection to family and kinship

Connections to family and kinship systems are central to the functioning of Aboriginal and Torres Strait Islander societies.

Connection to family and kinship risk factors

Absence of family members; family violence; child neglect and abuse; children in out-of-home care.

Connection to family and kinship protective factors

Loving, stable, accepting and supportive family; adequate income; culturally appropriate family-focused programs and services.

Connection to community

Community can take many forms. A connection to community provides opportunities for individuals and families to connect with each other, support each other and work together.

Connection to community risk factors

Family feuding; lateral violence; lack of local services; isolation; disengagement from community; lack of opportunities for employment in community settings.

Connection to community protective factors

Support networks; community-controlled services; self-governance.

Connection to culture

Connection to a culture provides a sense of continuity with the past and helps underpin a strong identity.

Connection to culture risk factors

Elders passing on without full opportunities to transmit culture; services that are not culturally safe; languages under threat.

Connection to culture protective factors

Contemporary expressions of culture; attending national and local cultural events; cultural institutions; cultural education; cultural involvement and participation.

Connection to Country

Connection to Country helps underpin identity and a sense of belonging.

Connection to Country risk factors

Restrictions on access to Country

Connection to Country protective factors

Time spent on Country

Connection to spirituality and ancestors

Spirituality provides a sense of purpose and meaning.

Connection to spirituality and ancestors risk factors

No connection to the spiritual dimension of life.

Connection to spirituality and ancestors protective factors

Opportunities to attend cultural events and ceremonies; contemporary expressions of spirituality.

'strongest protective factors' for Indigenous.

Cultural determinants are

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.

mental health problem:

a relatively short-term disruption that impacts on a persons everyday functioning

mental health problem info

• A person in the middle of the mental wellbeing continuum may have a mental health problem.

• typically recognised by the disruption that it causes to everyday functioning.

• problems typically do not last as long as mental disorders and may result in mild and temporary impairment.

• some disruption to their usual level of social and emotional wellbeing

• can be considered as natural responses to negative events in life that most people experience at some stage.

mental health problem characteristics

• increased or decreased sleep and appetite

• loss of energy and motivation

• difficulty concentrating

• difficulty focusing/completing work or study tasks

• irritability

• becoming withdrawn.

Mental disorders

a condition that affects mood, thinking, and behaviour and is typically long lasting

Mental disorders info

• also called mental illness

• mental health state that involves a combination of thoughts, feelings and/or behaviours which are usually associated with significant personal distress and impair the ability to function effectively in everyday life.

The essential characteristics of a mental disorder

: • the disorder occurs within the individual and results from dysfunction within the individual

• there is clinically diagnosable dysfunction in thoughts, feelings and/or behaviour e.g. low levels of functioning, social and emotional wellbeing

• causes significant personal distress or disability in functioning in everyday life

• actions and reactions are atypical of the person and inappropriate within their culture

• often lead to a person experiencing the three D’s: distress, dysfunction and deviance.

• reduced levels of day-to-day functioning

• reduced ability to cope with and manage change and uncertainty

• impaired ability to engage in social relationships

• significant changes in thoughts, feelings and behaviours or a lack of interest (apathy)

• serious or prolonged changes in typical character

• impaired ability to function independently, such as taking care of oneself at home.

Internal and external factors affect and are affected by

one another

Internal factors:

originate inside or within a person.

Psychological factors:

involve all those influences associated with mental processes such as our ways of thinking, beliefs

Biological factors:

involve physiologically based or genetic

E.g. genes, balances or imbalances in specific neurotransmitters

External factors:

originate outside a person.

Social Factors:

These can include school- and work-related factors, interpersonal relationships

The biopsychosocial approach is a

way of describing and explaining how biological, psychological and social factors combine and interact to influence a person’s mental health and wellbeing. (holistic view)

Internal factors examples

• Genetics

• • Sex

• • Neurotransmitter function

• • Hormones

• • Immune function

• • Nervous system activity

• • Negative thinking

• • Beliefs and attitudes

• • Emotions

• • Learning and memory

• • Personality traits

External factors examples

• Relationships

• Education level

• Income

• Social support

• Homelessness

• Experience of abuse

• Cultural values

• Employment

• Discrimination

Stress 

is a state of mental or emotional and physiological tension resulting from factors that are perceived to challenge or threaten our ability to cope.

Anxiety 

an emotion akin to worrying and uneasiness that something is wrong or something bad is going to happen, and is usually accompanied by physiological signs.

anxiety other info

It is an adaptive response and is usually helpful in the short term to deal with threats.

However, when anxiety is severe, disproportionate to the threat and does not subside, it can be counterproductive and disabling.

anxiety disorder’

describes when chronic and/or severe anxiety interferes with someone’s daily life and stops them doing what they want to do.

psychological factors examples

• Personality traits such as poor self-efficacy

• Rumination

• Impaired reasoning and coping skills

social factors examples

• Loss of a significant relationship

• Lack of support from family and friends (loneliness)

• Poverty

Specific phobia is an

anxiety disorder characterised by a marked and persistent fear or anxiety about a specific object, activity or situation.

Different types of Phobia

1. animal: e.g. spiders, snakes, mice, cats, dogs,

2. situational: e.g. flying/aeroplanes, driving, elevators, bridges, tunnels, enclosed spaces

3. natural environment: e.g. heights, storms, darkness, thunder, lightning, being near water

4. blood–injection–injury

5. other phobias: e.g. choking, vomiting, loud noises, costumed characters, falling down, becoming ill, dying.

how are phobias different from fear

• the fear or anxiety that is experienced is out of proportion to the actual danger posed by the phobic stimulus or to its context.

• irrational, often leads to avoidance behaviour whenever possible.

• They tend to unreasonably believe that they may be exposed to a traumatic event

• Fear or anxiety also typically result in a need to avoid any phobic stimulus.

A panic attack is

period of sudden onset of intense fear or terror, often associated with feelings of impending doom.

During the panic attack, there are

physiological or psychological changes such as shortness of breath; a racing or pounding heart; sweating; trembling; tightness in the chest etc

stress anxiety and phobia how r they experienced by everyone

There are many variations in how they are experienced by individuals

the development and progression of specific phobia is influenced by a

combination of biological, psychological and social factors, and the best treatment interventions are also based on a biopsychosocial approach.

biological factors which contribute to a specific phobia

1. Abnormalities in neurotransmitter function (GABA dysfunction) 

2. Role of LTP

social factors which contribute to a specific phobia

1. Precipitation by Classical Conditioning 

2. Perpetuation by Operant Conditioning 

3. Role of cognitive biases, including memory bias and catastrophic thinking

psychological factors which contribute to a specific phobia

1. Specific environmental triggers

2. Stigma around seeking treatment 

• If someone has a specific phobia, the exposure to a phobic stimulus typically triggers

an acute stress response involving physiological changes and possibly even a panic attack.

Anticipatory Anxiety

Is the gradual rise in anxiety level as a person thinks about, or ‘anticipates’, being exposed to a phobic stimulus in the future.

Long-term potentiation in Learning and Memory (specific phobia)

• Neuron connections change (plasticity) in response to our experiences -> enables learning and memory.

• Neuron connections influences how people acquire and retain fearful and anxious experiences

• LTP contributes to the development and maintenance of any type of specific phobia that is experience-based.

The ROLE OF GABA in specific phobias

• As we know, GABA is an inhibitory neurotransmitter -> making postsynaptic neurons less likely to fire counterbalances the excitatory activity of glutamate

• GABA and glutamate are important for regulating CNS arousal

• Without GABA, postsynaptic neurons might get out of control. -> causing seizures.

GABA in anxiety

Without the inhibitory effect of GABA, activation of postsynaptic neurons might get out of control. Their uncontrolled activation could spread throughout the brain, causing seizures like those of epilepsy. The inhibitory action of GABA means GABA acts as a calming agent.

People who have a phobia may have

too little GABA or have GABA dysfunction

Role of Long Term Potentiation in specific phobia and role of hippo and amygdala

• The more that the connection is activated through each encounter or anticipated encounter with a phobic stimulus, the more the connection is strengthened. The more the connection is strengthened, the more the relevant neural pathway is strengthened, increasing the efficiency in transferring fear information along the pathway and decreasing the likelihood that what has been learnt will be forgotten.

• The hippocampus would consolidate the memory that ‘spiders are scary’ and the intense physiological arousal that accompanies the thought each time they think of a spider is stored by the amygdala.

gaba dysfunction impact on phobia

Low level of GABA --> more vulnerable to anxiety, more likely to trigger F-F-F As there is less GABA produced, post synaptic neurons will be more likely to fire, increasing the chance of developing or maintain a phobia, as the individual will be more vulnerable to feeling anxious

ltp impact on phobia

Can enhance the association between a phobic stimulus and a fear/anxiety response through activity in the synapse --> decreasing the likelihood that what is learnt will be forgotten    Thinking of phobic experience --> bringing to conscious awareness --> retrieval process strengthens neural pathways The more the specific neural pathway is activated, the more easier it can be activated again, and strengthened. Hence causing the phobia to become more prominent.

Benzodiazepines

• increase GABA’s inhibitory effects. (also commonly known as sedatives, mild tranquillisers or depressants) it is GABA agonists

what do Benzodiazepines do

• slow down CNS activity to relieve symptoms of anxiety by reducing physiological arousal and promoting relaxation in the short term

How do Benzodiazepines work?

relieve symptoms of anxiety by reducing physiological arousal and promoting relaxation

they stimulate activity at the site of a postsynaptic neuron where GABA is received from a presynaptic neuron.

have inhibitory effects on postsynaptic neurons (increases GABA's inhibitory activity)

benzo con

-induce drowsiness, can be highly addictive (long term use is not recommended)

Benzodiazepine attaches to a GABA receptor, steps

changes the shape of the receptor ->  make it more receptive to the activity of GABA ->  amplify the impact of GABA

GABA agonists treat

symptoms not the cause

BENZO SHORT TERM USE

• Some people use a benzodiazepine intermittently to help cope with an occasional, unavoidable encounter with a phobic stimulus. (i.e. before flying)

• tend to be highly effective in reducing anxiety with few side-effects

• use of a benzodiazepine alone may alleviate symptoms

benzo LONG TERM USE

• can reduce alertness, abilities dependent on alertness (e.g. concentration, reaction time)

• can be addictive. Benzodiazepines can also lower inhibitions make some people more impulsive and likely to take risks

• benzodiazepines treat the symptoms and not the cause of anxiety. Once medication is stopped, symptoms may return if the underlying cause of the specific phobia has not been addressed.

• are not widely supported as a long-term solution for a specific phobia.

Research has found that many people with specific phobias develop abnormal breathing patterns

• hyperventilate (breathe faster and deeper than necessary)

• tachypnea (a pattern of uncontrolled rapid and shallow breathing)

low level of carbon dioxide in the blood -----> dizziness, light-headedness, blurred vision,  associated with a panic attack

Breathing retraining is an

anxiety management technique that involves teaching correct breathing habits to people with a specific phobia

Breathing retraining helps people to

maintain correct breathing or correct abnormal breathing patterns when anticipating or exposed to a phobic stimulus

help to reduce anxiety or alleviate some of its symptoms. help people feel more in control of their fear or anxiety

Breathing retraining other info

• can be used by itself or in combination with other treatments.

• Reduces the risk of over-breathing, increase the threshold for the onset of a panic attack and promote relaxation.

• help individuals manage the physiological arousal and tension they experience when exposed to a phobic stimulus.

• Breathing retraining also needs to be practiced

• Beneficial but does not cure phobia

biological protective factors PHOBIA

-use of gaba agonists

-controlled breathing and physical exercise

psychological protective factors PHOBIA

-cbt strategies and systematic desensitisation

social protective factors PHOBIA

psychoeducation for families/supporters

biological risk factors PHOBIA

gaba dysfunction, role of the stress response, LTP

psychological risk factors PHOBIA

classical conditioning, operant conditioning, cognitive bias: memory bias, catastrophic thinking

social risk factors PHOBIA

specific environmental triggers and stigma relating to receiving treatment

cognitive biases

catastrophic thinking and memory bias

Catastrophic thinking is a

thinking style which involves overestimating, exaggerating or magnifying an object, activity or situation and predicting the worst possible outcome.