[2Y2T2S] [PT10110] [1.1] Recognizing Psychopathology (Mental Health - Mood Disorders)

Mental health as Normal

• Absence of psychopathology

• Alleviation of gross pathologic signs and symptoms of illness

1. Above normal

2. Maturity

3. Positive psychology

4. Socioemotional intelligence

5. Subjective well-being

6. Resilience

Six (6) Models of Mental Health

Mental Health as Above Normal

• Reasonable, rather than an optimal, state of functioning

• Mental state that is objectively desirable

False: “Average” mental health is NOT HEALTHY

MENTAL HEALTH AS ABOVE NORMAL

True or False: “Average” mental health is healthy

Having the capacity to work and to love

MENTAL HEALTH AS ABOVE NORMAL

According to Freud, what is the objectively desirable mental state?

Healthy adult development

MENTAL HEALTH AS MATURITY

What is being defined below:

• Progressive brain myelination and also evolution of emotional and social intelligence through experience

A continuing process of maturational unfolding

MENTAL HEALTH AS MATURITY

Adult mental health reflects as?

True

They are less depressed + shows greater emotional modulation

MENTAL HEALTH AS MATURITY

True or False: Physically healthy 70 y/o are mentally healthier than they were at 30 y/o

Age: 13 y/o

Mature: Identity

Unresolved: Identity diffusion

Virtue: Fidelity

MENTAL HEALTH AS MATURITY

Erikson’s Model: Give the mature outcome, unresolved outcome, and associated virtue for 13 y/o

Age: 20s

Mature: Intimacy

Unresolved: Isolation

Virtue: Love

MENTAL HEALTH AS MATURITY

Erikson’s Model: Give the mature outcome, unresolved outcome, and associated virtue for the 20s

Age: 40s

Mature: Generativity

Unresolved: Stagnation

Virtue: Care

MENTAL HEALTH AS MATURITY

Erikson’s Model: Give the mature outcome, unresolved outcome, and associated virtue for the 40s

Age: 60s

Mature: Integrity

Unresolved: Despair

Virtue: Wisdom

MENTAL HEALTH AS MATURITY

Erikson’s Model: Give the mature outcome, unresolved outcome, and associated virtue for the 60s

Identity

MENTAL HEALTH AS MATURITY

Sustained separation from social, residential, economic, and ideological dependence on family of origin

Intimacy

MENTAL HEALTH AS MATURITY

Permits person to become reciprocally, not selfishly, involved with a partner

Career consolidation

MENTAL HEALTH AS MATURITY

Mastered together with or that follows the mastery of intimacy

Generativity

MENTAL HEALTH AS MATURITY

Clear capacity to care for and guide the next generation (good mentors)

Integrity

MENTAL HEALTH AS MATURITY

Achieving some sense of peace and unity with respect both to one’s life and to the world

1. Love

2. Hope

3. Joy

4. Forgiveness

5. Compassion

6. Faith

7. Awe

8. Gratitude

MENTAL HEALTH AS POSITIVE OR “SPIRITUAL” EMOTIONS

Give eight (8) positive emotions

1. Fear

2. Anger

MENTAL HEALTH AS POSITIVE OR “SPIRITUAL” EMOTIONS

Give two (2) negative emotions

Positive emotions

MENTAL HEALTH AS POSITIVE OR “SPIRITUAL” EMOTIONS

Positive or Negative:

Human connection

Negative emotions

MENTAL HEALTH AS POSITIVE OR “SPIRITUAL” EMOTIONS

Positive or Negative:

“me”

Positive emotions

MENTAL HEALTH AS POSITIVE OR “SPIRITUAL” EMOTIONS

Positive or Negative:

More expansive and help up to broaden and build

Negative emotions

MENTAL HEALTH AS POSITIVE OR “SPIRITUAL” EMOTIONS

Positive or Negative:

For survival in present time

Positive emotions

MENTAL HEALTH AS POSITIVE OR “SPIRITUAL” EMOTIONS

Positive or Negative:

Widen tolerance, expand moral compass, and enhance creativity

Negative emotions

MENTAL HEALTH AS POSITIVE OR “SPIRITUAL” EMOTIONS

Positive or Negative:

Narrow attention

Positive emotions

MENTAL HEALTH AS POSITIVE OR “SPIRITUAL” EMOTIONS

Positive or Negative:

Parasympathetic

Negative emotions

MENTAL HEALTH AS POSITIVE OR “SPIRITUAL” EMOTIONS

Positive or Negative:

Sympathetic

Positive emotions

MENTAL HEALTH AS POSITIVE OR “SPIRITUAL” EMOTIONS

Positive or Negative:

Contentment

Negative emotions

MENTAL HEALTH AS POSITIVE OR “SPIRITUAL” EMOTIONS

Positive or Negative:

Interfere with contentment but expression may be equally healthy

1. Better emotionally adjusted

2. More popular

3. More responsive to others

4. Do better in school and work

MENTAL HEALTH AS SOCIOEMOTIONAL INTELLIGENCE

Benefits of having socioemotional intelligence (4)

True

MENTAL HEALTH AS SOCIOEMOTIONAL INTELLIGENCE

True or False (underlined only): One criterion for social and emotional intelligence is having an accurate conscious perception and monitoring of one’s emotion

False: MODIFICATION OF EMOTIONS so that the expression is appropriate

MENTAL HEALTH AS SOCIOEMOTIONAL INTELLIGENCE

True or False (underlined only): One criterion for social and emotional intelligence is letting your emotions be as it is so that the expression is appropriate

True

MENTAL HEALTH AS SOCIOEMOTIONAL INTELLIGENCE

True or False (underlined only): One criterion for social and emotional intelligence is having accurate recognition of and response to emotions in others

False: Skill in NEGOTIATING CLOSE RELATIONSHIPS with others

MENTAL HEALTH AS SOCIOEMOTIONAL INTELLIGENCE

True or False (underlined only): One criterion for social and emotional intelligence is being skilled in negotiating as many relationships as you can with others

True

MENTAL HEALTH AS SOCIOEMOTIONAL INTELLIGENCE

True or False (underlined only): One criterion for social and emotional intelligence is having the capacity for focusing emotions towards a desired goal

True

MENTAL HEALTH AS SOCIOEMOTIONAL INTELLIGENCE

True or False: The more skilled individuals are in identifying their emotions, the more skilled they will be in communicating with others and empathically recognizing their emotions

False: The more skilled individuals are in empathy, the more they will be VALUED BY OTHERS

Will lead to greater support systems, self esteem, and intimate relationships

MENTAL HEALTH AS SOCIOEMOTIONAL INTELLIGENCE

True or False: The more skilled individuals are in empathy, the more they will be devalued by others and will be taken advantage of

True

MENTAL HEALTH AS SUBJECTIVE WELL-BEING

True or False: A happy person is satisfied with everything

1. Consciously seeking social support

2. Conscious cognitive strategies

3. Defense mechanisms

MENTAL HEALTH AS RESILIENCE

Give the three (3) broad classes of coping mechanisms to overcome stress

Defense mechanisms OR adaptive involuntary coping mechanisms

MENTAL HEALTH AS RESILIENCE

Distort our perception of internal and external reality in order to reduce subjective distress, anxiety, and depression

Mature defense mechanisms

MENTAL HEALTH AS RESILIENCE

What is being described below:

• Healthy and adaptive

• Socially adaptive and useful in integration of personal needs and motives, social demands, and interpersonal relations

• Underlie seemingly admirable and virtuous patterns of behavior

Humor

MENTAL HEALTH AS RESILIENCE

Defense mechanism: Permits the discharge of emotion without individual discomfort and without unpleasant effects on others

Altruism

MENTAL HEALTH AS RESILIENCE

Defense mechanism: Individual getting pleasure from giving to others what the individual would have liked to receive

Sublimation

MENTAL HEALTH AS RESILIENCE

Defense mechanism: Gratification of an impulse whose goal is retained but whose aim or object is changed from a social objectionable one to a socially valued one

Sublimation

MENTAL HEALTH AS RESILIENCE

Defense mechanism: Feelings are acknowledged, modified and directed toward a relatively significant person or goal so that modest instinctual satisfaction results

Suppression

MENTAL HEALTH AS RESILIENCE

Defense mechanism: Modulates emotional conflict or internal/external stressors through stoicism

Suppression

MENTAL HEALTH AS RESILIENCE

Defense mechanism: Minimizes and postpones but does not ignore gratification

Anticipation

MENTAL HEALTH AS RESILIENCE

Defense mechanism: Capacity to keep affective response to an unbearable future event in mind in manageable doses

DSM

Classification of mental disorders with associated criteria designed to facilitate more reliable diagnosis

Neurodevelopmental disorders

• Developmental deficits that impair personal, social, academic, or occupational functioning

• Onset:

  • Developmental period

    • Before child enters grade school

• Frequently co-occur with each other

Developmental period

When is the onset of neurodevelopmental disorders?

Intellectual disability

AKA Intellectual developmental disorder

Intellectual disability

• Deficits in general mental abilities

  • I.e. reasoning, problem solving, planning, abstract thinking, judgement, academic learning, and learning from experience

• Result in impaired adaptive functioning

• Failure to meet standards of personal independence and social responsibility

During the first 2 years of life

INTELLECTUAL DISABILITY

When is intellectual disability most severe?

False: Mild intellectual disability may not be identifiable until school age

INTELLECTUAL DISABILITY

True or False: Mild intellectual disability may be identifiable before school age

1. Genetic

   • i.e. Down syndrome

2. Acquired

   • Head trauma, meningitis, encephalitis

INTELLECTUAL DISABILITY

Two (2) causes of intellectual disability

Global developmental delay

INTELLECTUAL DISABILITY

What is the more appropriate diagnosis reserved for patients under the age of 5?

Yes

GLOBAL DEVELOPMENTAL DELAY

Does GDD require reassessment after a period of time?

Language disorder

Persistent difficulties in the acquisition and use of language across modalities (i.e. spoken, written, sign language, etc.)

1. Reduced vocabulary

2. Limited sentence structure

3. Impairments in discourse

LANGUAGE DISORDER

What are the three (3) deficits in comprehension or production caused by persistent difficulties?

True

LANGUAGE DISORDER

True or False: Individual differences in language ability are more stable

False: Language disorder diagnosed from 4 y/o is likely to be stable over time, and typically persists into adulthood

LANGUAGE DISORDER

True or False: Language disorder diagnosed from 5 y/o is likely to be stable over time, and typically persists into adulthood

Early developmental period

SPEECH SOUND DISORDER

When is the onset of Speech Sound Disorder?

Speech Sound Disorder

• Persistent difficulty with speech sound production that interferes with:

  • Speech intelligibility

  • Prevents verbal communication of message

• Limitations in effective communication

True

SPEECH SOUND DISORDER

True or False: The difficulties are not attributable to congenital or acquired conditions

Childhood Onset Fluency Disorder (Stuttering)

Disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual’s age and language skills which persist over time

Early developmental period

CHILDHOOD ONSET FLUENCY DISORDER

When is the onset?

True

CHILDHOOD ONSET FLUENCY DISORDER

True or False: The disturbance is not attributable to a speech-motor or sensory deficit, dysfluency associated with neurological insult, or another medical condition and is not better explained by another mental disorder

Social (Pragmatic) Communication Disorder

Persistent difficulties in the social use of verbal and nonverbal communication as manifested by:

• Deficits in using communication for social purposes

• Impairment of the ability to change communication to match context or the needs of the listener

• Difficulties following rules for conversation and storytelling

• Difficulties understanding what is not explicitly stated

Early developmental period

SOCIAL (PRAGMATIC) COMMUNICATION DISORDER

When is the onset?

Autism Spectrum Disorder

Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following deficits:

• Social-emotional reciprocity

• Nonverbal communicative behaviors

• Developing, maintaining, and understanding relationships

Autism Spectrum Disorder

• Presents restricted, repetitive patterns of behavior, interests or activities

• Symptoms can cause clinically significant impairment in important areas of current functioning

• Not better explained by intellectual disability or global developmental delay

1% of population

AUTISM SPECTRUM DISORDER

Prevalence of ASD?

1. May have intellectual and/or language impairment

2. Motor deficits (odd gait, clumsiness)

3. Self injury and disruptive or challenging behavior

4. Prone to anxiety and depression (during adolescence or adulthood)

AUTISM SPECTRUM DISORDER

Give four (4) other associated features

False: ASD is not a degenerative disorder

Learning and compensation can continue throughout life

AUTISM SPECTRUM DISORDER

True or False: ASD is a degenerative disorder

Functional language by age 5 = GOOD

AUTISM SPECTRUM DISORDER

At what age of functional language entails a good prognostic sign?`

70%

AUTISM SPECTRUM DISORDER

How many percent of ASD cases may have one comorbid mental disorder?

40%

AUTISM SPECTRUM DISORDER

How many percent of ASD cases may have 2 or more mental health problems?

Epilepsy = greater intellectual disability and lower verbal ability

AUTISM SPECTRUM DISORDER

Epilepsy = _______ intellectual disability and _____ verbal ability

1. Environmental

2. Genetic and physiological

AUTISM SPECTRUM DISORDER

Two (2) Risk Factors

1. Advanced parental age

2. Low birth weight

3. Fetal exposure to valproic acid

AUTISM SPECTRUM DISORDER

What are associated with environmental risk factor? (3)

37-90%

AUTISM SPECTRUM DISORDER

What is the heritability of ASD?

1. Rigid routine and aversion to change

2. Interference with sleep, eating, and make routine care

3. Difficult planning, organization and coping with change

4. Poor academic achievement

5. Difficulty establishing independence

6. Difficulty gaining employment

7. Social isolation

AUTISM SPECTRUM DISORDER

Functional consequences of ASD (7)

Attention Deficit/Hyperactivity Disorder (ADHD)

Impairing levels of inattention, disorganization, and/or hyperactivity (impulsivity)

Attention Deficit/Hyperactivity Disorder (ADHD)

Inability to stay on task, seeming to not listen, and losing materials

• Inconsistent with age or development

Attention Deficit/Hyperactivity Disorder (ADHD)

Overactivity, fidgeting, inability to stay seated, intrusive to other people’s activity, inability to way

• Excessive for age or developmental level

1. Inattention

2. Hyperactivity

3. Impulsivity

ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)

Three (3) main features of ADHD

At least 6 months

ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)

How long should inattention, hyperactivity, and impulsivity persist?

Prior to 12 y/o

ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)

Prior to what age should several inattentive or hyperactive-impulsive symptoms be present?

Two or more settings

ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)

In how many settings should several inattentive or hyperactive-impulsive symptoms be present?

5% of children

ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)

Prevalence in children?

2.5%

ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)

Prevalence in adults?

Hyperactivity

ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)

For preschoolers, ADHD manifests as?

Elementary years (w/ inattention)

ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)

When is ADHD often identified in?

True

ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)

True or False: ADHD is relatively stable through early adolescence

1. Temperamental

2. Environmental

3. Genetic and Physiological

ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)

Three (3) Risk Factors

x2-3 increased risk (but most do not develop ADHS)

ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)

For birth weight <1500 g, how much is the increased risk?

True

ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)

True or False: Smoking during pregnancy is a risk factor

False: ADHD is elevated in first-degree biological relatives

ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)

True or False: ADHD is not elevated in first-degree biological relatives

Developmental coordination disorder

NEURODEVELOPMENTAL MOTOR DISORDERS

• Deficits in acquisition and execution of coordinated motor skills

• Clumsiness and slowness or inaccuracy of performance of motor skills

  • Cause interference with ADLs