L7 Severe mental health disorders

What is 1 common affective change in mania?

Intense elated or irritable/agitated mood.

What 2 physiological changes occur during mania?

Decreased need for sleep and increased sense of energy

Name one behavioural change seen in mania

excessive involvement in pleasurable risk-taking activities

What are 3 cognitive changes during mania?

Inflated self-esteem, racing thoughts and distractibility

What is the difference between mania and hypomania?

Mania is more severe than hypomania, with significant disruption to daily life.

What is the life-time prevalence of mania

4-9%

What % of UK population in 2014 screened positive for bipolar disorder

2%

Common symptom of mania

mood swings

What do episodes of mania and hypomania often co-occur with

depression/low mood

2 nature of mania episodes

distinct (episode followed with period of depression) or concurrent (mania and depression mixed)

What is the key characteristic of Bipolar I disorder?

At least one manic episode

What distinguishes Bipolar II disorder from Bipolar I?

Bipolar II includes at least one hypomanic and one major depressive episode (not necessary for Bipolar I).

2 psychological factors of mania(?)

highly unstable and fluctuating self-esteem, and conflictual appraisals about mood and internal states

What is psychosis?

A loss of contact with reality, involving significant changes in thinking, perceiving, and behaving.

What issues with reality do people with psychosis have?

issues with telling the difference between “reality” and inner experiences

Define positive symptoms

the presence of states and experiences that most individuals do not normally experience

3 examples of positive symptoms (psychosis)

hallucinations, delusions and thought disorder

Define negative symptoms

the absence of emotional responses, thoughts processes and behaviours that are usual in mostly individuals (deficits)

5 examples of negative symptoms (psychosis)

alogia, avolition, reduced affect, anhedonia, and asociality

What is alogia

poverty of speech

what is it called when someone has a lack of motivation

avolition

what is reduced affect

inability to express (but can feel) ‘appropriate’ emotions

what is anhedonia

inability to experience pleasure

what is asociality

social withdrawal, lack of desire to engage in social interactions/form relationships

what is the nature of psychotic symptoms

continuum with normal functioning

what % of the population experience paranoid ideation

30%

what is paranoia

building on common worries

what % of the general population reported hallucinations

4%

are all psychotic experiences perceived as distressing

no, not inherently distressing

3 consequences of psychosis

severe distress, disability and mortality

Symptoms of psychosis can interfere with ?

a person’s functioning, social functioning and life goals

What is the lifetime risk of suicide in schizophrenia

5-10%

Psychological theory behind hallucinations (in psychotic experiences)

source monitoring biases (ability to distinguish internal and external cognitive events)

How can stress influence psychosis

disrupts source monitoring

3 psychological explanations for delusions/paranoia (in psychotic experiences) – cognitive bias

theory of mind difficulties, jumping to conclusion biases and attributional style

2 processes associated with psychotic distress

negative beliefs about the self and the world, and threatening appraisals

6 psychosocial risk factors associated with severe disorders

trauma, stressful life events, critical social relationships, urbanity, migrant status and social inequality/poverty

Define personality disorders

enduring, maladaptive patterns of thought, emotion, and behaviour across many contexts which differ markedly from those accepted by the individual’s culture and society

Two areas where personality disorders are particularly evident

expression and self-regulation of emotions, and interpersonal relationships

How do people with personality disorders struggle with feelings

experience overwhelming/intense negative feelings and difficulty managing them

What coping issue is often observed in personality disorders?

Use of harmful methods like self-harm or substance abuse.

Difficulties faced by people with personality disorders in relationships

maintaining stable and close relationships

The prevalence of difficulties faced by those with personality disorders is higher in high-income or low-income countries

high-income

What is a common stigma among professionals about personality disorders?

That people with personality disorders are manipulative or untreatable.

What approach helps overcome stigma?

A trauma-informed approach ("What happened to you?").

How does attachment theory explain personality difficulties?

Insecure attachment styles lead to emotional dysregulation