psych unit 4 aos 2 - mental wellbeing

3 characteristics of a mentally-well person

• high levels functioning

• high levels resilience to life stressors

• high levels social + emotional wellbeing

characteristics of a mentally-well person — high levels functioning

• ability carry out wide range daily activities, self-care, maintain relationships, resilient to everyday challenges

• higher overall ind level functioning = higher level functioning when face everyday challenges → ind is adaptive/resilient as these chals don’t sig impact their functioning

how can levels of functioning be assessed

WHODAS (WHO disability assessment schedule) questionnaire

— assesses 6 life domains:

• cognition (understanding + communicating)

• mobility (moving + getting around)

• self-care (hygiene, dressing, eating, staying alone)

• getting along (interacting with ppl)

• life activities (domestic responsibilities, leisure, work, school)

• participation (joining comm activities)

characteristics of a mentally-well person — high levels resilience

• resilience = ability to adapt + cope when stressors arise to return to high functioning state (bounce back better than before)

• inds mentally healthy learn from stressful exp → next time face smth similar they can use coping strats to adjust

characteristics of a mentally-well person — high levels social + emotional health

• social wellbeing = based on ability to have satisfying relationships + interactions with others

  — develop +ve bonds with fam and friends

  — respect ppl from diff ethnic + cultural backgrounds

  — work part of team

  — contribute to comm some way (e.g. volunteering)

• emotional wellbeing = based on ability control emotions + express them appropriately

  — express range emotions relevant to context

  — control diff emotions + respond to them +vely

  — act +vely and have +ve affect

  — identify emotions others and respond appropriately

  — respond with appropriate emotions to setbacks

ATSI social and emotional wellbeing framework (SEWB)

— holistic ATSI understanding of social + emotional wellbeing that varies between diff groups

framework model seven domains (bmfs ccc) :

• body

• mind + emotions

• fam and kinship

• spirituality + ancestors

• community

• culture

• country

framework model 3 determinants:

• social determinants

• historical determinants

• political determinants

ATSI social and emotional wellbeing framework domains — body

physical aspect of person h+w & how ind perceives and connects with their bodies

• risk factors e.g. = chronic disease, poor diet

• protective factors e.g. = healthy diet, exercise

ATSI social and emotional wellbeing framework domains — mind and emotions

• managing thoughts and feelings

• risk factors e.g. = racism, mental illness

• protective factors e.g. = education, assertiveness and confidence

ATSI social and emotional wellbeing framework domains — fam and kinship

• goes beyond fam, includes cultural roles and shared responsibilities, identity, and support systems

• risk factors e.g. = fam members absence, fam violence, child abuse/removal

• protective factors e.g. = supportive fam, adequate income

ATSI social and emotional wellbeing framework domains — community

• gives opportunities for inds connect + support each other

• risk factors e.g. = isolation, fam fueding

• protective factors e.g. = support networks, comm services

ATSI social and emotional wellbeing framework domains — culture

• gives sense of continuity with past + builds strong identity — includes cultural expression

• risk factors e.g. = elders premature passing, languages under threat

• protective factors e.g. = cultural institutions, attention local cultural events

ATSI social and emotional wellbeing framework domains — Country (land)

• deep experience of belonging to Country + trad and spiritual associations to kin and culture

• risk factors e.g. = restricted access to country

• protective factors e.g. = time spent on country to heal body + mind + spirit, cultural renewal

• lands, waters, skies which First Nations peoples are connected thru ancestral ties?

ATSI social and emotional wellbeing framework domains — spirituality + ancestors

• knowledge and belief systems + the Dreaming + cultural healing practices + value of wisdom and hope

• risk factors e.g. = mission life and assimilation (stolen gens?)

• protective factors e.g. = attending cultural events and ceremonies

ATSI social and emotional wellbeing framework determinants

• social determinants = how ppl grow, live, work and systems to deal with illness

  — e.g. SES, poverty impact, racism

• political determinants = ongoing influence of events, policies → can cause trauma on grps

  — e.g. past gov policies for colonisation → stolen gens → loss of culture

• historical determinants = policies shape resource distribution

FAQ summary for ATSI SEWB

• ATSI have holistic view h+w for thousands yrs

• framework is unique to ATSI

• defs of framework vary across diff cultural grps

• changes thru life span

• places ind (self) within network of relationships (domains) → quality of ind’s connections to these domains is what influences their s + e wellbeing (experiences and expressions)

• self is inseparable from each domain

mental wellbeing def

state of emotional and social wellbeing which inds can cope with normal life stressors, work productively and contribute to community

mental wellbeing continuum def + explanation

tool used to track progression of mental w which constantly changes over time (progresses from mentally well to mental wellbeing problems to mental health disorders)

• mw viewed in varying degrees on continuum

• mw not fixed in one position on continuum → mw fluctuates over time bc diff life exps → always constantly changing at point in time too (NEVER STATIC)

the mental wellbeing continuum

MENTAL WELLNESS

• person has high levels functioning, high levels social and emotional wellbeing, high level resilience to stressors (can adapt when facing challenges)

MENTAL WELLBEING PROBLEMS

• involves temp disturbance to mental wellbeing (rough patch in lives)

• temp decrease functioning, temp decrease social and emotional wellbeing, temp decrease resilience but person can still bounce back

MENTALLY ILL / MENTAL HEALTH DISORDER

• involves severe disturbance to mental wellbeing that ongoing for weeks/months

• low levels functioning (struggle functioning independently, effectively), low levels emotional and social wellbeing, low levels resilience to challenges

high mental wellbeing def

beneficial emotional state where ind realises their abilities

• copes with normal life stressors

• works productively

• contributes to comm

mental wellbeing problems def

psychological state temporarily hindered by a disturbance to normal functioning → has -ve but not sever impact on everyday functioning

mental health disorder def

psychological state where there’s a severe disturbance and sense of distress which sig impacts ind’s ability to function independently

characteristics of mental health

• mental wellness = form +ve relationships with others, cope with normal stressors of everyday life, think logically, manage emotions, experience enjoyment, use abilities to reach potential

• mental wellbeing problems = feel tense + low + irritable, unusual sleep or appetite, loss of energy and motivation, difficulty concentration, become withdrawn

• mental illness (disorder) = e.g. anxiety disorder (phobia), mood disorder (depression), psychotic disorder (schizophrenia), impulse control disorder (pathological gambling)

factors that affect mental wellbeing (and where we are on continuum)

• internal factors = influences originate from within ind

• external factors = influences originate outside ind from envo

— note: can interact with each other to influence ind’s mental wellbeing

factors that affect mental wellbeing — internal factors

PSYCHOLOGICAL FACTORS:

• self esteem

• personality traits

• emotions

• thought processes

BIOLOGICAL FACTORS:

• genetics (g predisposition)

• hormones

• neurotransmitter balances

• diet

factors that affect mental wellbeing — external factors

• healthcare access

• fam and friends support

• education

• abusive experiences

• loss of sig relationships

• stressor exposure

• cultural background influences (e.g. trads)

• social stigma exposure

what accounts for ind differences in mental wellbeing

• complex interaction of multiple factors

• external factors influencing ind’s internal envo (e.g. drug exposure → impact internal hormone levels)

stress def

psychobiological experience occurs when ind. encounters smth that demands their attention + efforts to cope

anxiety def

state of physiological arousal when ind think they cannot cope with stressor that may face in future

phobia def

excessive/unreasonable fear directed towards particular object, situation, event → cause sig distress + interfere with everyday functioning

phobic stimulus def

specific object or situation prod fear associated with phobia

physiological symptoms when experiencing stress, anxiety, phobia

same as flight-fight-freeze response (sympathetic ns activates)

compare and contrast — stress and anxiety

• SIMILARITY = sympathetic NS becomes dominant, potential contributory to mental health disorder

• DIFF = stress response to known stimulus, anxiety response can be to unknown or generalised stimulus AND stress can be eustress or distress, anxiety is distress only

compare and contrast — stress and specific phobia

• SIMILARITY = response to known stimulus, sympathetic ns becomes dominant

• DIFF = stress can sometimes be adaptive, phobia is maladaptive AND stress is potential contributory factor to mental health disorder but phobia is diagnosable mental health disorder

— specific phobia is a diagnosed mental health disorder but stress can only attribute to development of one?

compare and contrast — anxiety and specific phobia

• SIMILARITY = sympathetic ns becomes dominant, distress only, influenced by biological psychological social factors

• DIFF = anxiety response can be to unknown or generalised stimulus, but specific phobia response is to known stimulus AND anxiety can impact person functioning if not managed but phobia significantly impacts person functioning

— specific phobia is a diagnosed mental health disorder but anxiety can only attribute to development of one?

biopsychosocial factors that contribute to phobia development

• biological = GABA dysfunction, LTP

• psychological = behavioural models (precipitation by CC, perpetuation by OC, cognitive bias like memory bias and catastrophic thinking)

• social = specific envo triggers, stigma for seeking treatment

— memory hack = LG OCES (ltp, gaba, operant c, classical c, envo triggers, stigma)

for diagnosis of a specific phobia…

symptoms must be present 6 or more months + disrupt ind’s life (esp social or work relationships) or cause them serious distress

biopsychosocial factors that contribute to phobia development — BIOLOGICAL

involves internal and physiologically based factors

biopsychosocial factors that contribute to phobia development — BIOLOGICAL = GABA DYSFUNCTION

• gamma-amino butyric acid is primary inhibitory neurotransmitter in CNS

• GABA reduces likelihood of post-synaptic neurons firing → reduces brain activity so neural transmission not excessive

• GABA dysfunction = sig low levels GABA → neural activity sig increase throughout brain → cause overthinking → easily triggered FFF response → can lead to development like specific phobias

• low levels GABA = high levels anxiety (FFF activation)

strategies to raise GABA levels

• sleep better

• improve microbiome

• regular exercise

• deep breathing

GABA levels in brain can be negatively influenced by

• genetic inheritance

• NS damage

• exposure prolonged stress

• nutritional deficencies e.g. B6

• high caffeine intake

— they can:

• inhibit GABA release

• inhibit GABA ability bind to post-s neurons

• stimulate over-prod of glutamate

biopsychosocial factors that contribute to phobia development — BIOLOGICAL = LONG-TERM POTENTIATION

• LTP = long-lasting strengthening synaptic connections that regularly coactivated, increasing efficiency neural transmission

• repeated pairing phobic stimulus with fear response (FFF) → cause stronger connections for neural pathways associated with this → ind more likely react fearful way to specific stimulus

EXTRA KNOWLEDGE = LTP 2 neural pathways of fear response

1. phobic stimulus → thalamus send info from sensory neurons to sensory cortex → to amygdala (implicit memory to be scared of stimulus) and hippocampus (explicit memory that stimulus is smth to fear)→ amygdala signal hypothalamus initiate FFF response

2. phobic stimulus → send info from sensory neurons to amygdala directly → FFF initiated before sc and hippoc works out why response occurring

the more these pathways used to specific phobic stimulus → more these neural connections strengthen

biopsychosocial factors that contribute to phobia development — PSYCHOLOGICAL def

thoughts and mental processes that lead to development of specific phobia

— has behavioural and cognitive models

psychological factors : behavioural vs cognitive models

• behavioural = only on external observable behaviour — OC and CC

• cognitive = focus on internal mental processes — inaccurate mental processes can develop phobias (cognitive bias) — memory bias, catastrophic thinking

biopsychosocial factors that contribute to phobia development — PSYCHOLOGICAL = CLASSICAL CONDITIONING

• behavioural model

repeated pairing of NS (phobic stimulus) with UCS (unpleasant stimulus) can cause phobic reaction (CR) to the NS

biopsychosocial factors that contribute to phobia development — PSYCHOLOGICAL = OPERANT CONDITIONING

• behavioural model

after acquiring phobia via CC → phobia maintained with avoidance to phobic stimulus so reduce unpleasant fear feelings → avoidance = negative reinforcement (removal of undesired fear feelings)

precipitation and perpetuation def

• perception = development (of phobia via CC)

• perpetuation = maintenance (of phobia via OC)

two-factor theory of conditioning a phobia

phobia occurs thru CC (precipitated) and supported thru OC (perpetuated)

• CC = UCS (fear causing stimulus) paired with NS (to become the phobic stimulus as CS) leads to CR (phobia, fear, anxiety)

• OC = antecedent (envo cue to expose to phobic stimulus, the CS) → behaviour (avoid this CS) → consequence (fearful feelings removed) → behaviour maintained due to negative reinforcement

biopsychosocial factors that contribute to phobia development — PSYCHOLOGICAL = COGNITIVE MODELS

• inaccurate mental processes developing and maintaining phobia → pairing faulty reasoning with fearful stimulus so faulty cognition formed

biopsychosocial factors that contribute to phobia development — PSYCHOLOGICAL = COGNITIVE BIAS - memory bias

• error in thinking that can impair or enhance memory recall / alter memory’s contents

• can recall -ve info more readily than +ve info about specific stimulus from memory → contribute to phobia development

biopsychosocial factors that contribute to phobia development — PSYCHOLOGICAL = COGNITIVE BIAS - catastrophic thinking

• occurs after memory bias formed when ind repeatedly overestimates potential dangers of stimulus and assumes worst

— predict future outcome that others consider unrealistic and irrational

— ind exp increased distress and anxiety levels + underestimate their ability to cope with situation

biopsychosocial factors that contribute to phobia development — SOCIAL = ENVO TRIGGERS

• exposure to traumatic event that increase risk developing phobias

• the more severe the trauma associated with an experience → more likely phobia develop

biopsychosocial factors that contribute to phobia development — SOCIAL = STIGMA FOR SEEKING TREATMENT

• stigma about getting help for mental disorders (including phobias) prevents ppl seeking treatment → prolong phobia and can get worse over time

— ind may feel like others think they are overreacting and may fear ridicule (esp if phobic stimulus harmless)

— ppl around sufferer perceive behaviour to be irrational → hard to understanding and empathise with sufferer

biopsychosocial interventions for phobias

• BIOLOGICAL = short-acting anti-anxiety benzodiazepine agents (GABA antagonists) in management of phobic anxiety and breathing retraining

• PSYCHOLOGICAL = cognitive behavioural therapy (CBT) + systematic desensitisation as psychotherapeutic phobia treatments

• SOCIAL = psychoeducation for fams/supporters with reference to challenging unrealistic or anxious thoughts + not encouraging avoidance behaviours

BBC SP (benzodiazepines, breathing retraining, CBT, systematic desensitisation, psychoeducation

— note all these interventions can be used as protective factors for inhibiting phobia development

biopsychosocial interventions for phobias — BIOLOGICAL

specific targeting of bod processes to assist in minimising symptoms of phobia

biopsychosocial interventions for phobias — BIOLOGICAL = benzodiazapines

• anti-anxiety drugs used in short term to calm body (initiate parasympathetic ns)

• GABA agonist by imitating GABA’s inhibitory effects on post-s neurons thru brain

• depressant and induce symptoms like sleepiness, relaxation

  if used long term can lead to tolerance and addiction

• increase efficiency of GABA

• reduce physiological symptoms but doesn’t cure phobias or anxiety

• dangerous to use in high dosages → if dose increased can lead to coma or death

agonist drugs def

stimulate post-s neuron to fire by binding to matching shaped receptors and enhancing activity

biopsychosocial interventions for phobias — BIOLOGICAL = BREATHING RETRAINING

• ppl experiencing phobia → symptom of excessive breathing → can upset balance of O and CO2 → cause dizziness, blurred vision, panic attack, heightened feelings fear and anxiety

• breathing retraining → teach person to consciously slow their breath when experiencing anxiety

• reduces physiological arousal for phobic response by restoring balance O and CO2 + activates parasympathetic response

biopsychosocial interventions for phobias — PSYCHOLOGICAL = CBT

• target thoughts and behaviours that perpetuate phobia → if ppl change the way they think about smth then can change behaviour to it

• cognitive = using knowledge and info to overcome irrational thinking → replace with reasonable, realistic thinking

• behavioural = mod unhelpful behaviours that developed bc of faulty cognitions

• technique = identify anxiety related thoughts and cognitive biases → check evidence that rejects these biases → replace irrational thoughts to evidence based rational thoughts → use systematic desensitisation to distract from or reduce fear to give inds technique to actually cope in fearful situations

biopsychosocial interventions for phobias — PSYCHOLOGICAL = SYSTEMATIC DESENSITISATION

• unlearning connection between anxiety and specific phobia stimulus + reassociating feelings of relaxation and safety with that stimulus

• teach ind relaxation technique → break down anxiety-arousing stimulus into sequence arranged from least to most anxiety-producing (fear hierarchy) → pair items in hierarchy with relaxation by working thru items one step at time → at final stage ind should able to expose directly to phobic stimulus and stay calm

biopsychosocial interventions for phobias — SOCIAL = PSYCHOEDUCATION FOR FAMS/SUPPORTERS

• educate fams/supporters of those with specific phobia with info about disorder, how triggered, how can assist in management

• encouraged to help by:

  — challenging unrealistic thoughts

  — not encouraging avoidant behaviours

biopsychosocial model to influence mental wellbeing

• biological factors = originate internally and relate to physiological functioning

• psychological factors = originate internally and relate to non-physical functioning

• social factors = originiate externally from envo around person

protective factors for mental wellbeing

+ve influences that enable ind to promote and maintain high levels mental wellbeing

biopsychosocial model to influence mental wellbeing — biological protective factors

• adequate nutrition intake and hydration

• adequate sleep

biopsychosocial model to influence mental wellbeing — BIOLOGICAL = ADEQUATE NUTRITIONAL INTAKE AND HYDRATION

• consuming enough nutrients ad vitamins that body needs to function well → gives enough energy to function effectively in daily life → improves physical and mental wellbeing

• reduces risk physical health issues, aids sleep + energy levels + mood + mental health

• hydration with water imp for keeping body functioning

• strategies for ind to achieve adequate nutrition and hydration:

  — eat balanced diet of fresh fruits, veges, protein, carbs

  — drinking at least 2-3 L water per day

  — limiting fast food, alcohol, caffeine consumption

  — not skipping meals, eat regularly thru day

biopsychosocial model to influence mental wellbeing — BIOLOGICAL = ADEQUATE SLEEP

• regularly getting rec hours sleep for your age → refreshes and repairs body + resources to cope with daily needs

• uninterrupted REM sleep imp for mental health as assists brain to process emotional content

• helps us think, feel, perform better of life + enhance enjoyment

biopsychosocial model to influence mental wellbeing — psychological protective factors

• mindfulness meditation

• cognitive behavioural strategies

biopsychosocial model to influence mental wellbeing — PSYCHOLOGICAL = MINDFULNESS MEDITATION

• mindfulness = being focused on present moment

• meditation = calming the mind and focus on smth specific

• involves observing present moment and focusing on smth calm and peaceful (e.g. picturing somewhere calming like the beach)

• takes practice, used few mins each day to benefit wellbeing

• reduces rumination + stress, boosts working memory, allows greater focus

biopsychosocial model to influence mental wellbeing — PSYCHOLOGICAL = COGNITIVE BEHAVIOURAL STRATEGIES

• undergo cognitive behavioural therapy

• focus on changing ways ppl think to influence behaviour

• replacing unhealthy thinking patterns with helpful ways of thinking → can influence behaviour and mood

• increase ind resilience level by equipping them with strategies to manage challenging situations

biopsychosocial model to influence mental wellbeing — social protective factors

• support from fam, friends, comm that authentic and energising

biopsychosocial model to influence mental wellbeing — SOCIAL = SUPPORT FROM FAM, FRIENDS, COMM THAT AUTHENTIC AND ENERGISING

• support = genuine and effective assistance from fam, friends, comm

• can give comfort + reassurance and encourage inds to develop diff strategies to promote mental wellbeing

• must be authentic and energising:

  — gen aims to promote mental wellbeing

  — focused on creating envo likely to improve mental wellbeing

  — legitimate and effective advice

• e.g. unconditional love when ind makes mistake

• e.g. support in difficult times like providing distractions from difficult emotions

• e.g. sense of belonging and connection to wider circle

culture def

characteristics and knowledge of particular grp

• can involve lang, music, religion, food etc

• often also includes shared patterns of behaviours, interactions, understandings learned via socialisation

• way of life for ppl that shared and learned

• provides sense of belonging, influences ppl nature → hence imp to ppl → hence ppl want their culture passed onto members of comm

to promote ATSI wellbeing must consider

health holistically — not only physical health but cultural determinants of wellbeing too

cultural factors that support good h+w

• cultural continuity

• self-determination

cultural factors that support good h+w — cultural continuity

passing down and active practice cultural knowledge, traditions and values from gen to gen

• ability to preserve historical trads of culture and carry them forward into future

• ability for ATSI to practice culture not always been present bc of European colonisers denial → impacted their ability to maintain cultural continuity

• enables comms to heal and form strong identities → vital cultural determinant for re-establishment and maintenance of wellbeing

• how? — lang programs so young FN can learn mother tongues so they can build identity and cultural expression

cultural factors that support good h+w — self determination

right for ATSI make decisions on matters affecting their lives and comms

• colonisation meant this was lost → contributed to sig low levels wellbeing

• requires FN be involved in every layer of decision making

• can include endeavours like: aboriginal comm-controlled orgs, land resources and management, partnerships with gov orgs

HOW SELF-DETERMINATION IMPROVES SWEB FOR FN PEOPLE

• empowerment = FN have control over their affairs like health and education → gain sense of autonomy → increased self-esteem and greater sense purpose

• cultural safety in services = when FN face cultural barriers when accessing mainstream services like healthcare and education → self-d can create culturally safe services → meets unique social and emotional needs of comm