AOS 4

wellbeing

a state in which an individual is mentally, physically and socially healthy and secure

mental wellbeing

an individuals psychological state including their ability to think, process information and regulate emotions

to be mental health means to be

a state of well-being where you can cope with normal life stress, work well, realize your personal abilities, and help your community

3 ways of considering mental wellbeing

levels of functioning, resilience and social and emotional wellbeing

levels of functioning

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, be productive in completing daily tasks, set goals and take steps towards achieving them and adapt to changes in the environment

characteristics of low levels of functioning

struggle to carry out basic tasks, being unproductive in achieving tasks, lack direction to be able to set goals in life and be unable to cope with changes in the environment

resilience

the ability to cope with and manage change and uncertainty

characteristics of high levels of resilience

seek solutions to problems, use appropriate coping strategies, be flexible in changing circumstances and be optimistic and hopeful

characteristics of low levels of resilience

experience enduring feelings of being overwhelmed when problem arise, rely on unhealthy or unhelpful coping strategies, unable to adapt to change and lack of hope or optimism

social wellbeing

the ability for an individual to form and maintain meaningful bonds with others, and adapt to different social situations

characteristics of high levels of social wellbeing

have a strong support network, be able to form and maintain meaningful, relationships and be able to effectively communicate with others

characteristics of low levels of social wellbeing

be isolated or lack support from others, have difficulty forming and maintaining meaningful relationships and struggle to effectively communicate with others

emotional wellbeing

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

characteristics of high levels of emotional wellbeing

be aware of their own and others’ current emotional state, experience a wide range of emotions and express emotions at appropriate times

characteristics of 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 and express emotions inappropriately or at inappropriate times

Social and emotional wellbeing (SEWB)

a framework that includes all elements of being, and therefore wellbeing, for Aboriginal and Torres Strait Islander peoples

SEWB framework is

multidimensional and holistic

multidimensional

made up of different components

holistic

an approach to wellbeing that considers the whole person

7 domains

emotions, body, kinship, community, culture, Country and ancestors

body

connecting to the physical body and health in order to participate fully in all aspects of life

emotions

Ability to effectively manage thoughts and feelings

kinship

Connection to the immediate and wider family group and community

community

Connection to wider social systems

culture

A strong sense of identity, values, tradition, and connection between the past, present, and future that drives behaviour and beliefs

Country

The traditional lands of a particular language or cultural group, both geographically and the spiritual, emotional, and intellectual connections to and within it

ancestors

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

4 determinants

social, cultural, political and historical

social

the circumstances in which people grow, live and work, and the systems put in place to deal with illness

political

Political policies that shape the process of distributing resources and power to individuals and communities, and create or reinforce social and health inequalities

cultural

the impact on SEWB of cultural factors such as family background, religion, social norms, and traditions

historical

the ongoing influence of events, policies, and trauma on groups of people

mental wellbeing continuum

a tool used to track fluctuating mental wellbeing

characteristics of 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 and still may experience stress, sadness, and anger, however, have high levels of mental wellbeing due to their ability to cope with these experiences, regulate emotions, and express them appropriately

characteristics of moderate levels of mental wellbeing

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 and is more likely to experience irrational thought patterns

characteristics of 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 and may be diagnosed by a mental health professional and may be treated through psychotherapy or medication

5 categorised types of mental illnesses

mood disorders, psychotic disorders, anxiety disorders, personality disorders and addiction disorders

2 types of factors influencing mental wellbeing

internal and external

internal factors

factors that arise from within the individual

external factors

factors that arise from an individuals’s environment

2 ways these factors can influence a person’s mental wellbeing

They can contribute to the development or progression of low levels of mental wellbeing and they can protect an individual from the development or progression of low levels of wellbeing, instead maintaining high levels of mental wellbeing

2 types of internal factors of biopsychosocial model

biological and psychological

external factor of biopsychosocial model

social

biological factors

involves physiologically based or determined influence often not under persons control

examples of biological factors

inherited genes, sex, response to medication, brain and nervous system functioning, hormonal activities, physical health and response to stress

psychological factors

influences associated with mental processes

examples of psychological factors

our thoughts, ways of thinking, beliefs, attitudes, our skills in interacting with others, prior learning, perceptions and how we experience emotions and manage stress

social factors

conditions in which people live and grow

examples of social factors

school and work related factors, range and quality of our interpersonal relationships, amount of support available, exposure to stress, risk of violence and access to healthcare

stress

psychological and physiological experience that occurs when an individual encounters something of significance that demands their attention and/or efforts to cope

anxiety

a psychological and physiological response that involves feelings of worry and apprehension about a perceived threat

anxiety and stress are similar as…

people will experience both stress and anxiety from time to time, and it is an expected part of daily life.

they 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

anxiety and stress are different as…

anxiety is only negative feelings where as stress can be both positive (eustress) and negative (distress)

stress is usually a response of a known source whereas anxiety is usually unknown and worrying about events that could happen in the future

specific phobia

a type of diagnosable anxiety disorder that is categorised by excessive and disproportionate fear when encountering or anticipating the encounter of a particular stimulus

specific phobias are associated with

an individual going to great lengths to avoid their phobia stimulus, significant disruption to an individuals daily functioning and low levels of mental well-being when encountering or attempting to avoid the phobic stimulus

for stress, anxiety and specific phobia what is the dominant NS

all sympathetic

for stress, anxiety and specific phobia what is the type of stimulus

stress and specific phobia is known stimulus and anxiety is unknown

for stress, anxiety and specific phobia are they eustress or distress

stress can be both and anxiety and specific is distress

for stress, anxiety and specific phobia where are they place on the mental wellbeing continuum

stress and anxiety can fluctuates between low to high levels of mental wellbeing, depending on the severity and length of time and specific phobia is associated with low levels of mental wellbeing

for stress, anxiety and specific phobia are they adaptive or maladaptive

stress and anxiety can be adaptive in the short term, but becomes maladaptive when it is persistent and impairs functioning and specific phobia is always maladaptive

2 biological factors that will contribute to the development and maintenance of specific phobia

GABA dysfunction and the role of long-term potentiation

GABA

the main inhibitory neurotransmitter in the NS

GABA dysfunction

insufficient neural transmission or reception of GABA in the body

GABA dysfunction can contribute to the development of phobia because

GABA dysfunction may cause someone’s flight-or-fight-or-freeze or anxiety response to be activated more easily than someone with adequate GABA levels. This means that the stress response is more easily triggered by certain stimuli. And recurrent stress responses to specific stimuli can lead to the development of a phobia.

long-term potentiation

the long-lasting and experience-dependent strengthening of synaptic connections that are regularly coactivated

steps of long-term potentiation in the development of specific phobia

repeated coactiviation of free response unreal pathway and perception of phobia neural pathway which then strengthens phobia response

3 psychological factors that contribute to the maintenance and development of specific phobia

classical conditioning, operant conditioning and cognitive biases

classical conditioning contains … factors

precipitating

precipitating factors

increase the susceptibility to and contribute to the occurrence of developing a specific phobia

steps of classical conditioning

before conditioning
neutral stimulus → no response
unconditioned stimulus → unconditioned response

during conditioning
neutral stimulus + unconditioned stimulus (either once or repeatedly) → unconditioned response

after conditioning
conditioned stimulus → conditioned response

operant conditioning contains … factors

perpetuating

perpetuating factors

factors that inhibit a person’s ability to recover from a specific phobia

steps of operant conditioning

antecedent - phobic stimulus

behaviour - individual avoids phobic stimulus

consequence - individual avoids fear response which is negative reinforcement

cognitive bias

a predisposition to think about and process information in a certain way

2 types of cognitive bias

memory bias and catastrophic thinking

memory bias

caused by inaccurate or exaggerated memory

catastrophic thinking

a stimulus or event is predicted to be far worse than it actually is

2 social factors contributing to phobia

specific environmental triggers and stigma around seeking treatment

specific environmental triggers

stimuli or experiences in a person's environment that evoke an extreme stress response leading to the development of a phobia

examples of environmental tiggers

direct confrontation with a traumatic stimulus or event, observing another person having a direct confrontation with a traumatic stimulus or event and learning about a potentially dangerous or traumatic stimulus or event indirectly

stigma

the feeling of shame or disgrace experienced by an individual for a characteristic tray differentiates them from others

stigma around seeking treatment

people will not seek help due to embarrassment, worry or fear

two types of biological interventions

GABA agonists and breathing retaining

benzodiazepines

a type of medication that depresses central nervous system activity and is often used as a short-acting anti-anxiety medication

agonists

a type of drug that imitates neurotransmitters and works to initiate a neural response when it binds to the receptor site of a nueron

how do benzodiazepines work

1. Benzodiazepines bind to a GABA receptor site on a postsynaptic neuron.

2. The benzodiazepines increase the effectiveness of GABA when it later binds to the same receptor sites and mimics its effects.

3. GABA is able to then have its inhibitory effect, reducing the likelihood that the neuron will fire. This acts temporarily to reduce neural communication, in turn reducing anxiety.

breathing retraining

a method used to teach breathing control techniques that may reduce physiological arousal

examples of breathing retraining

slow and deep inhalations, followed by slow and controlled exhalations, counting slowly when breathing in, and when breathing out or breathing slowly in through the nose, and focusing on breathing out slowly from the diaphragm

how breathing retraining is used with a person with specific phobia

person is taught how to control their breathing consciously and then applies it when in the presence of a phobic stimulus

2 psychological interventions

cognitive behavioural therapy and systematic desensitisation

psychotherapeutic treatments

treatments that address dysfunctional emotions, thoughts and behaviours through therapeutic communication

cognitive behavioural therapy

encourages individuals to substitute dysfunctional cognitions and behaviours with more adaptive ones

the cognitive component involves

identifying negative thoughts and feelings about the issue and replacing these negative thoughts and feelings with more positive ones.

the behavioural components involves

identifying negative behaviours relating to the issue and developing and maintaining more positive behaviours relating to the issue

cognitions that may contribute to and perpetuate specific phobia

Memory bias, Catastrophic thinking, A belief that the phobia can never be overcome, A belief that the phobia can only get worse, Embarrassment and Extreme fear

behaviours that may contribute to and perpetuate specific phobia

Avoidance behaviours in which a person avoids their phobic stimulus and anything related to it at all costs, Not seeking help and Avoiding social activities that may expose a person to their phobia

systematic desensitisation

involves a patient being exposed incrementally to increasingly anxiety-inducing stimuli, combined with the use of relaxation techniques

a fear hierarchy

a list of anxiety-inducing experiences relating to the phobia in order of least to most easiest to confront

process of systematic desensitisation

1. learn relaxation techniques

2. create a fear hierarchy

3. gradual step by step exposure to each item fear hierarchy

4. continue exposure to items on the fear hierarchy until the most fear inducing stimulus can be faced without producing a phobia response