PS1110 exam

What is health?

State of complete physical, mental and social wellbeing, not merely the absence of disease

What is mental health?

State of wellbeing in which every individual realises their own potential, can cope with common stresses of life, work productively and able to contribute to family friends…

What is a mental health condition?

Broad term covering mental disorders and psychosocial abilities

What is a mental disorder?

Syndrome characterised by clinically significant disturbances in an individual’s cognition, emotion regulation or behaviour that reflects a dysfunction in the psychological, biological or developmental processes that underlie mental and behavioural functioning

What is a psychosocial disability?

Disability that arises with someone with LT mental impairment interacts with various barriers that may hinder full and effective participation in society on equal basis with others

What are some examples of psychosocial disabilities?

Discrimination/stigma/exclusion

What 4 things do WHO say about mental health?

Basic human right/influences how we think, feel and act/important to personal, community and socio-economic development/as important as physical heath

WHO 2022-mental health has intrinsic and instrumental value helping us to…

Connect/function/cope/thrive

WHO 2022-interplay of 3 factors that vary over time and space that are risk factors

Individual/community/structure

Risk factors are a complex interaction of… and… and…

Individual vulnerability/life event stressors/chronic stressors

List some risk factors for mental health conditions?

Conflict/disease outbreaks/social injustice…

Risk factors that occur during… are particularly detrimental

Developmentally sensitive periods

Comprised environments affect… and increase 3 things

Brain/risk/severity/duration

Gender, ethnic grouping, place of residence-increase risk of… and…

Social exclusion/economic adversity

Socially marginalised individuals are at a greater risk of… and have more difficulty accessing…

Mental health conditions/health services

Mental ill-health linked to poverty starts…

Before birth and can accumulate throughout life

Poverty means individuals have…

Less financial resources/fewer educational opportunities/less able to access health care

Protective factors build…

Resilience

Protective factors include:

Positive parenting/quality education/employment

What was the aim of the WHO initiative for mental health and wellbeing?

Increase mental health care provision, 100 million more people

3 steps towards transforming attitudes towards mental health

Shift attitudes/reshape environment/strengthen mental health care

Since 1999 over… articles have been published on wellbeing

170,000

Most research on wellbeing uses

Assessment of subjective mental wellbeing

What is happiness?

Life satisfaction/presence of positive mood/absence of negative mood

What is a hedonistic view of wellbeing?

Positive mood/avoid pain and negative mood (Ryan & Deci, 2001)

What is a eudaimonic view of wellbeing?

Self actualisation/personal growth (Ryan & Deci, 2001)

Difference between hedonistic and eudaimonic view of wellbeing?

Pleasure and pain VS meaning

Waterman 1993 stated that people live in accordance with their daimon or true self and this is known as…?

Personal expressiveness

La Placa et al 2013 - 5 things that combine to make up wellbeing

Individual/social/economic/political/environmental

What are the four main components of the Knight & McNaught (2011) wellbeing framework ?

Society/community/family/individual

In 2007 BIG Lottery Fund awarded the Greater London Authority... for Alliance to deliver Well London

£9.46m

Phase 1 of Well London reached how many participants?

17,000

What were the percentages of improvement for mental wellbeing, physical activity and healthy eating due to Well London?

86/83/60

Waltham Forest Well London-Heart of the Community activities

Camping trips/bike projects/women’s pampering sessions

What are the two general perspectives of wellbeing?

Hedonism/eudaimonism

WHO states disturbances to mental health involve…

Combination of troubled thoughts, emotions, behaviour and relationships of others

Medical perspective VS mental health condition

Mental disorders… VS person centred

Mental health epidemiology

Study of distribution of mental health conditions

Prevalence

Number of active cases in a population at any given period of time (%)

Incidence

Number of new cases that occur over a given time (less than prevalence)

What are the 3 types of prevalence?

Point/1 year/life time

Point prevalence

Estimated proportion of active cases of a condition in a given population at a given point in time

1 year prevalence

Everyone who experience condition at any point in time throughout entire year

Life time prevalence

Number of people with particular condition at any time in their lives (both currently ill and recovered)

Steel et al 2014

136 studies/26 high income countries/37 low and middle income countries/17.6% experience common mental health condition in last year/29.2% across lifetime

Steel et al 2014 found females more likely to experience… or… conditions

Mood/anxiety

Steel et al 2014 found males were more likely to experience.. or… abuse

Alcohol/substance

WHO 2022-global 1 year prevalence 2019

Varies with sex and age/anxiety and depressive disorders most common/anxiety disorders prevalent at young age/depressive disorders most common in adults

WHO 2022-Depression and anxiety during COVID

Significant increase in those with depression (28%) and anxiety (26%)/countries hit hardest had greatest ^ disorder prevalence/^ females/^ younger

Two methods of criteria for mental health

DSM-5/ICD-11

DSM-5 definition of mental disorders

Clinically significant disturbance in cognition, emotion regulation or behaviour that indicate a dysfunction in mental functioning that is usually associated with significant distress or disability in work, relationships or other areas of functioning

What 4 things must someone do in order to be considered to have a mental disorder?

Violate social norm/violate statistical norm/personal distress/disability or dysfunction in behaviour

What constitutes as violating a societal norm?

Not following conventional social and moral rules of cultural group

What is the issue with the concept of violating a social norm?

Vary over place and time

Good example of social norms varying over time

Homosexuality/disorder by WHO until 1980

Give an example of behaviours that do not violate societal norms but that are considered a disorder

Depression

What is the issue with violating a statistical norm as a criteria for mental disorders?

Statistically infrequent or rare behaviour could be considered maladaptive

What is the issue with personal distress as a criteria for mental conditions?

Does not apply to all disorders (antisocial PD/highs in BPD)

Personal distress as a criteria can also apply to expected or adaptive responses like…

Bereavement/war

Disability or dysfunction in behaviour can affect what 3 groups?

Individual/those around/society

What is the point in classifying disorders?

Identify meaningful clusters of maladaptive behaviour

What are the advantages of classifying disorders?

Common nomenclature/structure information in helpful way/identify causes and treatments/insurance reimbursement…

Disadvantages to classifying mental disorders

Shorthand leads to loss of information/stigma/stereotyping/labelling change in self concept

2 approaches to classification of disorders

Categorical/dimensional

Categorical classification

Presence of absence of a symptom pattern/qualitative differences between normal and abnormal/arbitrary cutoffs

Dimensional classification

Symptoms vary on continuum/differences are quantitative/worrying>GAD

How do we explain mental health conditions?

Cognitive/genetic/social/neurobiology/clinical/developmental/evolutionary

Genetic influences

Most mental health conditions show some genetic influence/abnormalities in genes=polymorphisms/additive genes that can ^ vulnerability/affect behaviour indirectly

Intrauterine

Internal

Genotype-environment intractions

Genetic factors not sufficient to cause MHC but contribute to vulnerability if significant stressor

Genotype-environment interactions are hard to identify, why?

Many different genetic risk factors/many different kinds of environmental events/large numbers needed for research studies

Caspi et al 2003 genotype-environment interactions

850 ppts/age 3-adult/specific genes transport serotonin/variant with 2 short alleles who experience 4 or more major life stressors had x2 risk of developing major depression VS 2 long alleles variant

Caspi et al 2003 replicated by… but not…

Karg et al 2010/Culverhouse et al 2017

Culverhouse et al 2017 depression

70 institutions/31 datasets/40,000 people/association negative life events and depression/no serotonin gene or genotype-environment interaction

In ancient times mental disorders were attributed to…

Possession by demons or gods

Demonic possession was treated through…

Exorcism

In ancient times, addictions were thought of as…

Sins

Greek and Roman thought stated that mental disorder had…

Natural causes and appropriate treatments

Greeks and Romans believed mental disorders were due to…

Brain pathology (imbalanced fluids)

Greek and Roman treatments emphasised…

Changes in lifestyle

Greek ideas survive in the…

Middle East

500-1500 AD in Europe, what gained influence?

Churches (exorcism, witch hunting…)

Late middle ages/early Renaissance, what replaces witchcraft at the current theory of mental disorders?

Madness

Johann Weyer 1515-1588 argued that those argued to be witches were really…

Suffering from mental illnesses and were sick

During what century were asylums established?

16th

The establishment of asylums lead to the notion that…

The mentally ill should be confined and removed from society instead of scientifically treated

What was Bedlam asylum and when was it set up? But when was it made into an asylum?

Monastery/1243/1547

Who took action in France in 1792 engaging in Humanitarian Reform and removing the chains of inmates and treating them kindly?

Phillipe Pinel

Work similar to that of Pinel was carried out by which 2 men?

William Tuke/Benjamin Rush

What was moral management?

Rehabilitation of character through manual labour and spiritual discussion

How many mental hospitals did Dorothea Dix establish?

32

What did William Tuke do?

Established the York Retreat in 1792

What did Benjamin Rush do?

Advocated for use of moral treatment

In the early 19th century, asylums were controlled not by doctors but by…

Laypersons

Nervous exhaustion was considered a treatable disorder when?

Late 19th century

From 1946 onwards there was a greater attention to…

Care in hospitals due to public concern

By the late 20th century, use of medication for disorders was introduced such as…

Lithium for depression

When was there an effort to close mental hospitals? (deinstitutionalisation)

Late 20th century

What % of adults does grief persist enough to cause problems?

7-10

Prolonged Grief Disorder

Loss of loved one over year ago (adults) 6 months (child)/experience 3 symptoms nearly everyday for last month/bereavement lasts longer than expected