Stage 2 Psychology: Psychological Health and Wellbeing

Define Mental Health

‘Mental health is a state of wellbeing in which an individual realises their own abilities, can cope with the normal stresses of life, can work productively and is able to contribute to their community.’

What is used to diagnose mental disorders?

The Diagnostic and Statistical Manual (DSM-5)

What is a mental disorder, according to the DSM-5?

Syndromes characterised by clinically significant disturbances in an individual's cognition, emotional regulation, or behaviour that reflects a dysfunction in psychological, biological or developmental processes underlying mental functioning.

What are biological factors that affect health and wellbeing? Treatment options?

Biological

•Changes in hormones

•Infections

•Neuroanatomy changes (tumours, head trauma, degenerative diseases)

•Genetics.

Treatment

•Medical therapies i.e. drugs and ECT.

What are psychological factors that affect health and wellbeing? Treatment options?

Psychological

Perception

•Cognition

•Attention

•Emotion

•Motivation

•Decision-making

•Volition and behaviour control.

Treatment

•Communication & behavioural exercises.

What are social factors that affect health and wellbeing?

Social

•Racism

•Poverty

•Dysfunctional institutions

•Oppression

•Poor family communication.

What is Behaviour Modification? What are the ethics?

•An intervention used by psychologists to modify a specific maladaptive behaviour.

•A formal step by step process.

•Behaviours that are learned can be ‘unlearned.’

Ethics of Using Behaviour Modification

•Changing behaviours could do harm.

•Example: Taking a phone away from a child.

•Positives: Promote healthy sleeping and reducing screen time.

•Negatives: If anxious may cause unnecessary distress.

What are the 4 theories of sleep needs?

Repair and Restoration, Clean-Up, Evolutionary, Information Consolidation

Explain repair and restoration theory

•While you sleep your body:

•Repairs cells

•Restores basic body functions

•Makes proteins.

•Signals in the brain that control your sleep/wake state also turn the immune system off and on.

• During sleep, the immune system strengthens / heals. If this does not occur, the body gets sick, and mental health is affected.

Explain clean-up theory

•While you sleep the brain flushes out built up waste products from the brain and the body.

•Research suggests Dementia, Parkinson's and Alzheimer’s may be influenced by a lack of clean-up.

• While you sleep, the body clears out toxins that are harmful: preventing headaches and negative brain health.

Explain evolutionary theory

•Sleep is used to conserve energy.

•Humans are most productive during the day when we can eat food for energy.

•According to evolution we couldn’t get food at night so slept to conserve energy.

•All animals have adapted to being awake when it is dangerous and sleep when it is safe.

Explain sleep consolidation theory

•Sleep has many stages, deep sleep and REM sleep have a role in memory retention, consolidation and culling unwanted information.

•Sleep ensures storing and consolidation of information from sensory to short and finally to long term memory.

•Research shows fewer hours of sleep decreases our ability to recall and remember information thus affects our memory.

Explain sleep deprivation: symptoms and effects

•Today’s average is 6 hours sleep.

•This means many people are sleep deprived.

•Symptoms: increased daytime sleepiness, irritability, hand tremors, headaches, slower reaction time, poorer memory and microsleeps.

•Consistent reduction of recommended sleep can increase: the risk of cancer, infection, obesity, cardiovascular disease, diabetes in adults, anxiety and depression. 

What are the two types of sleep deprivation?

•Partial: not getting enough sleep most days of the week.

•Continuous: not sleeping for an extended period of time. Rare outside lab conditions, is used in training exercises for the army.

What are Social Factors that affect Sleep Deprivation?

Co-sleeping and parenting choices

•Bed sharing, room sharing, sleeping with a baby or pet disrupts sleep.

Media use

•The more time spent on media, the harder it is to fall asleep = less sleep, which leads to insomnia and depression.

Personal choices

•Voluntary choices like staying up late to watch TV.

Shift work

•Work that falls outside 6:00am-7:00pm.

•Includes: nursing, medicine, factory work, vintage work, hospitality.

•1 in 5 shift workers develop shift work disorder.

Jet lag

•Internal body clock doesn’t match your surroundings if you travel through several time zones.

•On average, 1 hour time zone change = 1 day of adjustment.

What are Psychological Factors that affect Sleep Deprivation?

Stress

•Heightened state of physiological arousal.

•43% of people aged between 13-64 have reported lying awake at night due to stress at least once in the past month.

Mental Health Disorders

•Anxiety disorders and depression influence ability to fall asleep and stay asleep so reduce sleep time.

What are Biological Factors that affect Sleep Deprivation?

Medical or health problems

•Pain, substance misuse, obesity all reduce sleep time.

Sleep disorders

•Insomnia, sleep apnoea and narcolepsy all reduce sleep time.

Delayed Sleep Phase Syndrome

•When a person’s sleep is delayed by 2+ hours of what is considered acceptable.

•Causes difficulty in waking up at a desired time.

•Affects approximately 7-16% of young people.

What are some tips for improving sleep?

• Keep a consistent sleep schedule. Get up and got to bed at the same time each day, give or take 30min.

• Set a bedtime early enough so you can get 8-10 hours sleep.

• Don’t go to bed unless tired.

• If you can’t fall asleep after 20 minutes, get out of bed and do an activity in low light.

• Establish a bedtime routine.

• Use your bed for sleep and sex only.

• Sleep only in your bed.

What is stress and stressors?

•Stress is a normal physiological and psychological response people develop in response to things that happen in our everyday lives.

•Things in our life that are upsetting, scary or difficult = Stressors.

What are the 4 types of stress?

•Eustress

•Distress

•Acute Stress

•Chronic Stress

Explain Eustress

•Positive, helpful and motivating.

•Example: professional athletes being nervous before a game.

Explain Distress

•Negative, unhelpful form of stress.

•Leads to feeling overwhelmed, anxious and symptomatic: headaches, irritability, insomnia, stomach upsets.

•Example: worrying excessively about an upcoming test.

Explain Acute Stress

•Caused by daily demands and pressure.

•Can be intense but appears and disappears quickly.

Explain Chronic Stress

•Caused by a persistent or long-term stressor (typically uncontrollable).

•Not as intense but longer lasting, leading to the depletion of the body’s natural resources.

•Leads to an increased risk of physical and mental health issues.

What are the 3 Sources of Stress?

•Daily Pressures

•Life events

•Catastrophes that disrupt whole communities

What are some examples of daily pressures?

Daily Pressures

•Relatively minor troubles that arise daily = ‘hassles.’

•Irritants or small problems that bother us/make us angry.

•Because they are so typical, they are often not identified.

•On their own not a problem but can ‘pile up.’

•Increase in hassles = increase in biological and psychological symptoms.

What are some examples of life events?

Life Events

•Significant events that force us to adapt.

•Include choices we make and things that ‘just happen.’

•Can be positive and/or negative.

•Getting married.

•Having children.

•Social Readjustment Rating Scale was developed to help understand this source of stress.

•People who accumulate 200 points in a year have increased biological and psychological symptoms.

What are some examples of catastrophes that disrupt whole communities?

•A major event causing widespread damage and/or suffering simultaneously.

•Usually sudden and out of your control.

•Bushfire, flood, chemical spills, drought, bombings, genocide, epidemic. (Disasters).

•Can cause short and long term biological and psychological symptoms, long-term leads to Post Traumatic Stress Disorder (PTSD).

Explain the flight or fight response and the two divisions of ANS?

•When we face a stressor, the flight or fight response is triggered.

•This response is the same in all people and regardless of the type of stress.

•Our bodies stress response is controlled by the autonomic nervous system (ANS).

•The ANS has two divisions: sympathetic and parasympathetic.

What is the sympathetic nervous system?

•Activates the flight or fight response for survival.

•Useful short term, allows us to get things done, stay alert and motivated.

•Responsible for eustress.

•Not healthy for extended periods of time.

What is the parasympathetic nervous system?

•Returns the body's functioning to normal levels after the threat has passed.

•Maintains energy levels and supports everyday needs of body.

•Activates the freeze response.

What is GAS, and what are its 3 stages?

•‘General Adaptation Syndrome’ describes how the body deals with stress over an extended period.

•It has three stages:

•Alarm

•Resistance

•Exhaustion

Explain the 3 stages of GAS

1. ALARM: release of adrenaline and cortisol, flight or fight response occurs.

2. RESISTANCE: cortisol remains, and physiological responses remain slightly higher (alert). The parasympathetic nervous system tries to conserve the body’s energy by counteracting the physiological responses from alarm.

3. EXHAUSTION: the body can’t maintain arousal as energy sources are depleted. The immune system weakens, making us susceptible to illness.

What are the positives of stress response (Short Term)

•Adrenaline increases heart rate and blood pressure which mobilises energy supplies.

•Cortisol increases glucose in the blood which increases the brains use of glucose leading to tissue repair.

•Cortisol supresses non-useful systems of the body during a fight-flight-freeze response to conserve resources.

•In the short term it helps develop coping skills so we can deal with the stressor if faced again.

What are the negatives of stress response (Long Term)

•Anxiety and depression

•Digestive problems

•Headaches, pain

•Heart attack, high blood pressure, increased heart rate

•Stroke

•Sleep problems

Sweating

What is job burnout and what are the three dimensions of burnout?

•Most jobs are demanding at times the following makes certain jobs more demanding and stressful:

•Constant exposure to loud noises, constant harassment, threats of physical violence, perpetual frustration, or switching shifts.

•Burnout = physical and emotional exhaustion in relation to your job. Linked to the exhaustion phase of GAS.

Three dimensions of burnout:

•Exhaustion: emotional resources are gone.

•Depersonalisation: an indifference to work as emotional detachment between the person and their clients occurs.

•Lack of personal accomplishment: viewing your work negatively (feelings of failure or not being able to help others).

Explain Coping Strategies: what are the two strategies and two approach strategies?

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A set of tools/strategies used to avoid or reduce burnout, distress, acute and chronic stress.

•Can be positive or negative i.e. increase or decrease mental wellbeing.

Two types: Approach and Avoidant.

Approach has: Emotion-focussed strategies and Problem-focussed strategies.

•Approach: target stressor and do something about it. (More positive).

•Avoidant: avoid/escape threatening thoughts and emotions. (Less positive).

Approach strategies:

•Problem-focussed: aim to directly reduce the stressor.

•Emotion-focussed: aim to reduce the negative feelings connected to the stressor.

How were mental illnesses treated in history?

•In ancient times it was believed psychological distress was caused by demons, so exorcisms and trephination were used.

•Trephination = a procedure involving drilling holes into the skull.

•In the late 18^th - mid 19^th century Moral Therapy was brought to asylums.

•Moral Therapy = combination of rest, talk, prayer and manual work.

What are some problem-focused coping strategies?

Time management

•Taking control of organising and managing your time and energy.

Exercise

•An outlet for physical stress, releases muscle tension and uses up glucose and adrenaline.

Seeking Support

•Asking for help from a counsellor, psychologist, peer, family member to manage the stressful situation.

What are some emotion-focused coping strategies?

Meditation

•A reset such as watching our breath or meditating on a word, phrase or song.

Listen to calming music

•Music helps bring us into a state of calm so we can deal with the stressors.

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Create a safe, peaceful space

•A space that is quiet and safe where we can take time out to breathe and assess the situation.

Define mental illness

Behaviours, thoughts and emotions that significantly impair work, study or social functioning.

•Mental health exists on a continuum from good to bad.

Mental illness does notmean incapacity to live a functional life.

Define depression

What are biological factors that influence depression?

•Change in brain chemistry: reduced activity in the frontal lobe and weak connection to amygdala.

•Imbalance of neurotransmitters: serotonin, dopamine, and noradrenaline. (Specifically reduced levels of serotonin).

•Genetic predisposition.

•Overuse of substances (alcohol and drugs).

Symptoms: headaches, digestion issues, chronic pain, insomnia, appetite change, increased daytime fatigue, inactive left frontal lobe, reduced serotonin

What are psychological factors that influence depression?

•Personality types that are less flexible, strongly emotional or worriers.

•Psychological distress from neglect, abuse, trauma, chronic illness, bullying.

•Symptoms: sadness, low self-esteem, learned helplessness, self-harm, poor judgement, loss of pleasurable activities, reduced comprehension, impulsivity, pessimistic.

What are social factors that influence depression?

•People without supportive social networks. 

•Stigma in some cultures as depression is ‘shameful.’

•Natural disasters, COVID19, family death, conflict etc.

•Symptoms: reduced involvement with others, strained relationships, loss of/maladaptive social skills, victim or perpetrator of abuse. 

Define anxiety

There are many anxiety disorders, all include the experience of strong and/or frequent anxiety or fear.

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Different anxiety disorders include:

•Phobias

•Panic disorder

•Obsessive-compulsive disorder (OCD)

•Post traumatic stress disorder (PTSD)

•Generalised anxiety disorder (GAD)

•Social phobia.

What are biological factors that influence anxiety?

•Flight or fight response more active (overactive amygdala).

•Some research suggests there are genetic markers for vulnerability to anxiety disorders.

•Low levels of dopamine.

•High levels of serotonin.

•Symptoms: headaches, trembling, nausea, muscle tension, dizziness, insomnia, heart palpitations/chest pain, sweating, tingling sensations.

What are psychological factors that influence anxiety?

•Interpretation bias = perceive information from others as negative towards them.

•Impaired memory due to inattention and worry.

•Past experiences, personality, attitudes, beliefs and stress management skills.

•More likely in females than males.

•Symptoms: Magnifying threats and failures, fear, worrisome thoughts, irrational fears, fear of public scrutiny, hypersensitive to criticism, worried about potential mistakes, avoidance, persistent unwanted thoughts, feelings of anxiety, confusion, resentfulness, high neuroticism.

What are social factors that influence anxiety?

•Traumatic event based a person’s social, socioeconomic, political, religious or cultural affiliation.

•Examples: war, abuse, poverty, COVID19.

•Symptoms: fast paced lives, environmental stressors, decreased job security, lack of family support, avoidance of social contact, crowds, friendship or other groups, social phobias.

What are some biological treatments for anxiety and depression? What are the advantages and disadvantages of these?

Anti-depressant Medication (Anxiety/Depression)

•There are many but the most common in Australia are Selective Serotonin Reuptake Inhibitors (SSRIs).

•SSRIs correct the imbalance of the hormone or neurotransmitter.

•Enhance the function of nerve cells in the brain that regulate emotions.

Anti-anxiety Medication

•Most common are benzodiazepines.

•A type of tranquiliser and/or sleeping pill.

•Promote relaxation and reduce muscle tension.

Advantages

•Allows people to function effectively.

•With psychological therapy = more successful.

•Readily available in Australia.

•

Disadvantages

•Negative side effects.

•Addictive (benzodiazepines in particular).

•May take several trials of different medications to find the right one, and the right dosage.

•Can take a long time to work i.e. more than two weeks.

What are some psychological treatments for anxiety and depression? What are the advantages and disadvantages

Cognitive behavioural therapy (CBT)

•Structured psychological treatment which recognises how we think (cognition) and act (behaviour) affect feelings.

•Requires a professional therapist who identifies thought patterns linked to anxiety or depression.

•Makes clients aware of their thoughts and behaviours, so they can change them and improve coping skills.

•One of the most effective treatments for depression and anxiety for all age groups.

CBT

Advantages

•Longer, more extended success.

•Can reuse strategies if symptoms resurface.

•Applicable to all age groups, genders and demographics.

Disadvantages

•Thought processes can be difficult to change.

•Being diagnosed is confronting.

•Expensive.

•Time consuming (5-6 months and can be ongoing).

•Wait lists for psychologists are long.

What are some social treatments for anxiety and depression?

Support groups and services

•Belonging to a recognised support group.

•Hearing and talking to others who understands promotes belonging not loneliness.

•Can be done in person or online.

Define resilience and the features of a resilient person

Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress — such as family and relationship problems, serious health problems or workplace and financial stressors.

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It means "bouncing back from adversity”.

Features of resilient people:

•Sense of autonomy.

•Calm under pressure.

•Rational thought process.

•Positive self-esteem.

•Optimism.

•Happiness and emotional intelligence.

•Meaning and purpose.

•Humour.

Altruism, love and compassion.

What are the biological factors that affect resilience?

•Sleep – having a healthy amount of sleep enhances physical and mental health.

•Adrenaline – keeps us safe and strong in times of immediate stress.

•Cortisol – helps us handle long-term stress (as long as it doesn’t go into exhaustion of GAS).

•Exercise – releases endorphins which promotes good mental health.

•Eating – healthy, balanced diet keeps us physically fit and promotes mental fitness.

•Minimal use of drugs/alcohol as this can be used as a coping strategy.

What are the psychological factors that affect resilience?

•Cognition – positive mindset, seeing the optimistic side of life, confidence.

•Perception – believing we can cope and that things will turn out positively.

•Emotions – finding meaning in stressful situations and managing strong feelings.

•Learning – school achievement, IQ, problem-solving and planning.

•Memory – remembering you are supported and how you have coped before.

•Trait theory – high levels of stability and openness.

•Good Communication – the better we can communicate the better we handle stressful situations.

What are the social factors that affect resilience?

•Relationships – caring and supportive relationships within and outside of the family.

•Socio-economic advantage – steady income, access to support services.

•School/work – positive school/work environment.

•School achievement – recognition of achievements in school or work.

•Cultural pride – active, positive involvement in a culture or community.

What is the importance of resilience?

Importance of resilience:

•Improved learning and academic achievement.

•Lower absences from sickness.

•Reduced risk-taking behaviours.

•More community and family involvement.

•Lower rate of mortality.

•Increased immune functioning.

•Increased physical health.

What are some risk factors that increase ones likelihood of developing mental illness?

Genetic influences	Family disharmony or break up	Bullying	Socio-economic disadvantage
Low IQ and learning difficulties	Inconsistent discipline styles	Discrimination	Homelessness
Specific development  delay	Parent/s with mental illnesses and/or substance abuse	Breakdown or lack of positive friendships	Disaster, war, accidents or other overwhelming events
Communication difficulties	Physical, sexual and/or emotional abuse/neglect	Peer pressure	Discrimination
Physical Illness	Parental criminality or alcoholism	Poor pupil to teacher relationships	Other significant life events
Low-self esteem	Death and loss		Lack of access to support services

What are some protective measures that decrease the likelihood of mental illnesses?

Child	Family	School	Community
Secure attachment experience	Family harmony and stability	Positive school climate that enhances belonging and connectedness	Wider support network
Good communication skills	Supportive parenting	Clear policies on behaviour and bullying	Good housing
Having a belief in control	Strong family values	‘Open door’ policies for children who raise problems	High standard of living
Positive attitude	Affection	A whole school approach to promoting good mental health	Opportunities for valued social roles
Experiences of success and achievement	Clear, constant discipline		Range of sport/leisure activities
Capability to reflect	Support for education

What are the symptoms of sleep deprivation?

·       Daytime sleepiness

·       Irritability

·       Hand tremors

·       Poorer memory

·       Microsleeps

·       Slowed reaction time

·       Poor performance on a task

How much sleep should each age group achieve each night?

Age Group	Hours of sleep per 24 hours
Newborns	16
Toddlers	13
Adolescents	9-10
Adults	6-8
Elderly	6-8

What is insomnia?

Causes a reduction in quality and amount of sleep, making sufferers unable to function at their optimal level.

What is sleep apnoea?

Sleep disorder in which a person stops breathing periodically for a few moments whilst they are asleep.

What is narcolepsy?

Sleep disorder in which people experience irresistible and unpredictable daytime attacks of sleepiness, lasting 5 – 30 minutes.

Define sleep hygiene

Things in your behavioural control that can help you to have optimal sleep quality and quantity.

Define maladaptive behaviour

Everyday behaviour is impaired or affected. For example drugs and alcohol consumed to excess.

What is ECT? What are the disadvantages and advantages?

ELECTRIC SHOCK THERAPY (ECT)

Advantages

Modern day ECT very safe

Effective in treating severe cases

Disadvantages

Intrusive procedure

Can cause memory loss

May not work for everyone

What objective quantitative methods can be used to study sleep and stress?

SLEEP

·      EEG machine to measure brainwaves

STRESS

·      Polygraph test used to measure heart rates and other physiological measures

What subjective quantitative methods can be used to study sleep and stress?

SLEEP

·      Epworth sleepiness scale

·      Rating scales

STRESS

·      Rating scales on stress in certain situations

What qualitative methods can be used to study sleep and stress?

Qualitative

Focus groups, Delphi technique, interviews and surveys can all be used to measure both sleep and stress.

What are the ethics associated with this topic?

There is a duty of care and ethical code for professionals working with people who have a mental illness to protect their rights and dignities.

There is still great stigma in society towards mental illness, largely because people misunderstand mental illness

Diagnosis of a mental illness can be both helpful and harmful.

Diagnosis is fraught with difficulty, so to is treatment and what is most effective for patients

There are laws in place to protect people with a mental illness, this may mean involuntary admission to a psychiatric ward if you are considered a danger to yourself or others, however most psychiatric wards in Australia have a majority of patients that are there on a voluntary basis.