Psych- Unit 4 AOS2, Mental Wellbeing and Phobias

wellness

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

mental wellbeing

involves our state of mind, our enjoyment of life, and our ability to cope with the normal stresses of everyday life and develop to our potential

levels of functioning

the degree to which an individual can complete day-day tasks in an independent and effective manner

ways of considering mental wellbeing

• daily living skills

• interpersonal relationships

• emotions

• cognitive skills

• school/work setting

• leisure/recreational activities

adaptive behaviour

any behaviour that enables the individual to adjust to the environment appropriately and effectively.

maladaptive behaviour

any behaviour that’s detrimental, counterproductive, or interferes with the individual’s ability to successfully adjust to the environment and fulfill their roles in society

resilience

the ability to successfully cope with and manage change and uncertainty. it involves bouncing back from difficult experiences and restoring positive functioning

social wellbeing

the ability to form and maintain meaningful bonds with others and adapt to different social situations

emotional wellbeing

the ability to appropriately control and express their emotions in an adaptive way, as well as understand other’s emotions

the SEWB as holistic

reflects an approach to wellbeing that considers the whole person, including their mental, physical, spiritual, and social needs

the SEWB as multidimensional

it’s made up of different components

the social and emotional wellbeing (SEWB) view of mental wellbeing for Aboriginal and Torres Strait Islander peoples

a framework based on a holistic and multidimensional view of health. This framework explores 7 interconnected dimensions of wellbeing that enable a strong and positive Aboriginal or Torres Strait Islander identity. This framework also acknowledges that all aspects of social and emotional wellbeing are impacted by social, historical, and political determinants. These determinants signify that the experience of wellbeing is impacted by wider societal forces

social determinants

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

historical determinants

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

political determinants

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

connection to body

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

connection to mind and emotions

the ability to effectively manage thoughts and feelings

connection to family and kinship

connection to the immediate and wider family group and community

connection to community

connection to wider social systems, providing individuals and families the ability to connect with and support eachother

connection to culture

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

connection to country

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

connection to spirituality and ancestors

spirituality refers to a concept that connects all things, and shapes beliefs, values, and behaviour. It guides knowledge, systems, culture, and all that is life for Aboriginal people, including connections to ancestors, past, present, and future

ancestors refer to a belief that a community’s ancestors are interconnected with Creation spirits and Country, and watch over and protect families and communities in the physical and spiritual world

characteristics of high levels of mental wellbeing

• being able to function independently

• being able to cope with everyday demands without experiencing high levels of distress and dysfunction

• may still experience stress, sadness and anger, however can cope with these experiences, regulate emotions, and express them appropriately

characteristics of being in the middle of the continuum

• not functioning at an optimal level

• experiences temporary or moderate impacts on mental wellbeing

• experiences amplified emotions and high levels of stress

• has difficulty concentrating

• more likely to experience irrational thought patterns

• impacts tend to be less sever and temporary in nature

characteristics of low levels of mental wellbeing

• shows high levels of distress

• unable to independently complete tasks and meet the demands of their environment

• is impacted for an extended period of time

• may be diagnosed by a mental health professional

• display atypical and maladaptive behaviour

ways to measure a person’s place on the continuum

• level of change- is the behaviour atypical?

• time period- the longer symptoms persist, the greater likelihood of a disorder

• levels of distress- considers the amount of mental anguish, cognitive dysfunction, and self-harm

• severity of symptoms- impact, length, degree of change, level of distress

• degree to which functionality is impaired- eating, sleeping, self-care, work, socializing, cognitive ability

what influences an individual’s mental wellbeing

the interactions between internal and external factors, helping account for why we shift back and forth along the mental wellbeing continuum

internal factors

influences that originate inside a person. they include biological and psychological factors

biological factors

physiologically based or determined influences, often not under our control. however, they can also be under our control to some degree, such as diet and sleep hygiene

psychological factors

internal influences associated with mental processes, such as thinking, attitudes, prior learning, perceptions, problem-solving, our ability to understand and experience emotions, etc.

external factors

influences that originate outside a person. they can contribute to the development of low levels of mental wellbeing (risk factors), or help maintain high levels of mental wellbeing (protective factor)

Stress

a psychobiological response produced by internal or external stressors

characteristics of stress

• it is a normal part of life, and isn’t necessarily a sign of low levels of mental wellbeing

• mild amounts can be adaptive

• can be positive or negative (eustress vs. distress)

• it is usually in response to a known cause

• is a potential contributory factor to a mental health disorder

anxiety

a state of arousal involving feelings of apprehension or uneasiness that something unpleasant is about to happen

characteristics of anxiety

• it typically only involves negative feelings (distress only)

• it’s broader than stress and may be caused by an unknown stimulus

• it’s considered normal

• is a potential contributory factor to mental health disorders

phobia

a persistent, irrational fear of a particular object, activity, or situation, which is consequently either actively avoided or endured with marked distress

characteristics of phobias

• individual’s typically put a lot of effort in avoiding their phobic stimulus

• it’s maladaptive

• can cause significant disruption to daily functioning

• individual’s experience low levels of mental wellbeing when encountering the stimulus

• it’s a diagnosable mental disorder

specific phobia

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

characteristics of a specific phobia

• the phobic stimulus almost always triggers immediate fear or anxiety and is avoided or endured with intense fear or anxiety if avoidance isn’t possible

• tends to be irrational

• they’re usually able to recognise their fear is excessive/unreasonable

anticipatory anxiety

worry or apprehension about the possibility of being exposed to a phobic stimulus in the future

5 categories of phobias

Animal, situational, natural environment, blood-injection, other phobias

biopsychosocial approach

a holistic, interdisciplinary framework for understanding the human experience in terms of the influence of biological, psychological, and social factors.

social factors

external factors relating to an individual’s interactions with others and their external environment, including their relationships and community involvement

GABA dysfunction

the insufficient neural transmission or reception of GABA in the body. This can be due to low levels of GABA, or insufficient reception or transmission of GABA across the synapse. It can contribute to the development of a phobia because it causes a person’s stress response to be more easily activated by stimuli. Recurrent stress responses 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. This can contribute to the development of phobias by strengthening the association between neural signals involved in perceiving a stimulus and activating the fear response. This strengthening of neural pathways can also decrease the likelihood that what has been learnt will be forgotten

precipitation by classical conditioning

the perpetuation of a phobia through classical conditioning is the process by which a neutral or unconditioned stimulus becomes, by association, a sign of impending threat, danger, or some other unpleasant event (a conditioned stimulus). The innate, naturally occurring fear response (UCR) eventually becomes a conditioned fear response (CR). If the experience is highly traumatic, an individual can be conditioned to experience a fear response after one pairing of the NS and UCS

precipitating factors

factors that increase susceptibility or ‘trigger’ and contribute to the occurrence of developing a specific phobia

perpetuating factors

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

perpetuation by operant conditioning

operant conditioning involves learning through the association of a behaviour and the consequence it receives. it perpetuates phobias because individuals with a phobia typically avoid their phobic stimulus, meaning they’re negatively reinforced in not having to deal with their fear response. Over time, this reinforcement strengthens the phobic response, making avoidance behaviours more likely to be repeated and preventing recovery

cognitive biases

a predisposition to think about and process information in a certain way. this causes errors in people’s judgements and thoughts often leading to unreasonable conclusions. it’s considered to be a systematic errors and often happens without conscious awareness. It includes memory bias and catastrophic thinking

memory bias

a type of cognitive bias caused by inaccurate or exaggerated memory, only focusing on the negative or threatening information.

catastrophic thinking

a type of cognitive bias in which a stimulus or event is predicted to be far worse than it actually is. a person will often imagine ‘worst case’ scenarios, causing individuals to experience heightened feelings of helplessness and grossly underestimate their ability to cope with the situation.

specific environmental triggers

stimuli or experiences in a person’s environment that evoke an extreme stress response, leading to the development of a phobia. it can include direct confrontation, observing another person having direct confrontation with a traumatic stimulus, or learning about a potentially dangerous or traumatic stimulus/event indirectly

stigma

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

social stigma

the negative attitudes and beliefs held in the wider community that lead people to exclude, avoid, or unfairly discriminate against people with a mental health problem or disorder.

stigma around seeking treatment

the sense of shame a person might feel about getting professional help for their phobia, ad it can be difficult for others to understand or empathize with people who have an irrational fear of things that are otherwise deemed harmless. Some people with specific phobias also disguise their reality of their disorder by claiming it is caused by a plausible variable that is more readily accepted by society.

evidence-based interventions

treatments that have been found to be effective on the basis of scientific evidence. treatments are based on a thorough evaluation of evidence and are supplied by qualified professionals.

GABA agonists

drugs and medication that stimulate a neurotransmitters activity are called agonists. benzodiazepines are a type of medication that depresses the CNS activity and is often used as a short acting anti-anxiety medication. When a benzodiazepine attaches to a GABA receptor, it changes the shape of the receptor to make it be more receptive to the activity of GABA and consequently more resistant to excitation. However, if there is no GABA present at the receptor site of a postsynaptic neuron then there will be very little effect on the neuron. GABA agonists don’t directly treat the phobia, only reduces physiological symptoms

breathing retraining

a method used to teach breathing control techniques that aim to reduce physiological arousal. When experiencing a phobic reaction, individuals can hyperventilate or go into a pattern of tachypnoea, upsetting the balance of oxygen and carbon dioxide. This increases the sympathetic NS response and further exacerbates anxiety, causing light-headedness, dizziness, blurred vision, and pins and needles. This response can become habitual and therefore increase fear and anxiety. breathing retraining can give people control over their breathing, restoring levels of carbon dioxide in their blood.

cognitive behavioural therapy

a type of psychotherapy that combines cognitive and behavioural therapies to treat phobias and other mental health problems. the cognitive component involves identifying/challenging negative thoughts and feelings, and replacing these thoughts and feelings with more positive ones. this can often include educating the individual on the statistics of their phobia. the behavioural component involves identifying/challenging negative behaviours relating to the issue, and developing/maintaining more positive behaviours. this can often include not performing avoidance behaviours and employing relaxation techniques.

systematic desensitisation

a kind of behaviour therapy that aims to replace an anxiety response with a relaxation response when an individual with a specific phobia anticipates or encounters a fear stimulus. It applies principles of classical conditioning to unlearn the connection between anxiety and a specific object/situation. it involves 4 steps, learning relaxation techniques, developing a fear hierarchy, gradually exposing the individual step-by-step, and the continuation of the systematic exposure.

psychoeducation

involves the provision and explanation of information to individuals about their phobia to assist in their understanding of its characteristics and treatment. it can also involve educating the families and supporters of the individuals on how to recognise and challenge unrealistic thoughts and also discourage avoidance behaviours in a supportive and non-judgmental manner.

protective factors

factors that enhances and helps to protect mental wellbeing and reduces the likelihood that mental ill-health will occur, increasing a person’s ability to cope with stressors

risk factors

factors that increase the likelihood of experiencing mental ill-health, or can make existing mental health difficulties more sever.

biological protective factors

influences that stem from an individual’s brain and/or body that can maintain or promote mental wellbeing. It includes adequate nutritional intake and hydration, and adequate sleep

adequate nutritional intake and hydration

eating a variety of different foods and ensuring we drink enough water to maintain good physical health and feel mentally well as a result

adequate sleep

during sleep, the body undergoes repair and replenishes resources depleted during the major waking period. This includes triggering the release of hormones that affect growth and other functions, as well as giving our brain time to process info and form/consolidate new pathways/memories. There is a strong link between inadequate sleep and poor mental health, as inadequate sleep impairs both affective, cognitive, and behavioural functioning.

psychological protective factors

influences that stem from a person’s mind. people who have good mental wellbeing usually think logically and tend to have a positive view of themselves and life in general. they can establish positive thinking patterns and have the ability to identify and challenge maladaptive or unrealistic thoughts and expectations. this includes cognitive behavioural strategies

cognitive behavioural strategies

techniques drawn from cognitive behavioural therapy to identify, assess, and correct faulty patterns of thinking and problem behaviours that may be threatening or adversely affecting mental wellbeing.

cognitive strategies

strategies that target thinking. it includes cognitive restructuring which is the process of learning to identify, challenge, and modify/replace cognitive distortions with more reasonable and helpful ways of thinking

common cognitive distortions

• all-or-nothing

• mind-reading: you decide what others are thinking without checking

• fortune-telling: predicting negative outcomes

• magnification

• minimisation

• catastrophising

techniques used in cognitive restructuring

self-monitoring, socratic questioning, cost-benefit analysis

behavioural strategies

can be used to protect, maintain, or improve mental wellbeing through behaviour change. this includes behaviour activation and mindfulness meditation

behaviour activation

a process that involves identifying and scheduling activities that promote enjoyment.

mindfulness meditation

a type of meditation where a person focuses attention on their breathing, whilst thoughts, feelings, and sensations are experienced freely as they arise. this process can improve emotional reactivity, reduce the likelihood of rumination (repeated negative thoughts), reduce stress, and improve memory

social protective factors

influences that exist in an individual’s social environment that can maintain and promote mental wellbeing. this includes social support

social support

genuine and effective assistance provided by family, friends, and community. The support should be authentic and energising, genuinely aiming to promote mental wellbeing

kalokerinos

evidence-based tips for how to provide more effective social support to someone with a problem adversely affecting their mental wellbeing. the tips are:

1. validate first, reframe second

2. avoid downward spirals

3. be authentic and energising

4. listen well

5. be responsive, not dismissive