Applications Flashcards 5-7

Temperament

• Distinctive personality from first few weeks of life

  • Basic response tendencies

• Children have unique patterns of responding

  • Identical twins more similar in temperament than fraternal twins

• Thomas and Chess (2956) collected information about 9 dimensions of infant behaviour

  • Mood

  • Regularity of biological functions - sleep, feed

  • Tendency to approach or withdraw from novel stimuli

  • Intensity of emotional reactions

Temperament Classifications

• Easy Child (40%): Regular routines in infancy, cheerful and adapts to new experiences

• Difficult child (10%): Irregular routines, slow to accept new experienced and reacts negatively

  • Aggressive behaviour in school

• Slow-to-warm-up child (15%): Inactive, mild reactions, negative mood and adjusts slowly to new experienced

  • Fearfulness and slow behaviour in school

Attachment

• Emotional development begins shortly after birth

  • Attachments to caregiver

  • Strong, long lasting emotional ties to a person

• Develops across lifespan

• Bowlby's Attachment Theory

  • Attachment between mothers and newborns

  • Very early interactions curial to development

  • Feelings of security

  • Quality of attachment varies between infants

Attachment Classifications

• Secure Attachment - 65% of USA

  • Parent is a secure base

  • If cry, this is due to them preferring the parent to stranger

  • Actively seek parent upon return

  • Crying reduce immediately

• Avoidant attachment (20%)

  • Unresponsive to parent

  • Not distressed when parent leaves

  • Unresponsive to stranger

• Resistant attachment (10-15%)

  • Seek closeness and fail to explore

  • Angry and resistant when parent returns

• Disorganised-disorientated attachment (5-10%)

  • Greatest insecurity

  • Confused at reunion - look away while being held

What influences attachment security

• Quality of caregiving:

  • Secure attachment: Sensitive caregiving

  • Insecure attachment: Less contact

  • Childs temperament can influence this

• Opportunity for attachment:

  • Tizgard and Rees (1975) observed a children's home

  • High child-staff ratio, but high turn over of staff

  • First attachment after 4 years old

Adolesent - Autonomy and attachment

• Autonomy

  • Key developmental task of adolescence

  • Establish identity separate to parents

  • Secure attachment with parents still important

  • Naturally occurring 'strange situation'

Attachment and later development model

Internal working model: expectations from early caregiving experience concerning the availability of attachment figures and the self's interaction with those figures

Attachment Styles

Parenting Styles:

Moral Reasoning + types

• As child develop, they develop morality

  • Right or wrong?

  • Learn from authority figures and peers

• Preconventional morality (birth to 6 years old, stages 1 and 2) Base decision on right or wrong and the likelihood of avoiding punishment

• Conventional morality (7-12 years old, staged 3 and 4) Have internalised societies rules

• Postconventional morality (12 years onwards, stages 5 and 6) Able to look beyond fixed rules and focus on principles

Eriksons Stage Theory 1-2 - BA

• Stage 1: Basic trust vs basic mistrust

  • Birth to 12-18 months

  • Feeding

  • Form a loving relationship or develop a sense of mistrust

    • Optimistic vs pessimistic personality

• Stage 2: Autonomy vs shame and doubt

  • 18 months to 3 years

  • Toilet training

    • Success in toilet training and other skills such as dressing self requires control and gaining autonomy or failures may lead to feelings of shame

Erikson 3-4 - II

• Stage 3: Initiative vs guilt

  • 3-6 years

  • Gaining independence or it chastised for being forceful, leading to guilt

• Stage 4: Industry vs inferiority

  • 6-12 years

  • Staring school

  • Learn new skills or feel a sense of inferiority

Erikson 5-6 - II

• Stage 5: Identity vs identity confusion

  • Adolescence

  • Identity crisis

  • Influenced by previous stages

    • Weak trust: Difficulty selecting ideals to believe

    • Low autonomy: Little exploration of alternatives

    • Low industry: Difficulty selecting vocation which matches their interests

• Stage 6: Intimacy vs Isolation

  • Early adulthood

  • Commitment can be challenging

    • Surrender some independence and redefine themselves

  • Achievement of intimacy is marked by cooperation, tolerance and acceptance of different values

    • Promotes empathy and openness

  • Isolation is marked by hesitancy to form close relations

Erikson 7-8n- GE

• Stage 7: Generativity vs stagnation

  • Middle adulthood

  • Helping to guide the next generation

    • Commitment expands beyond yourself and partner

      • Concern for future generations

    • Anything that can outlive the individual

  • Stagnation: Self-indulgent, placing own comforts above sacrifice

• Stage 8: Ego integrity vs despair

  • Late adulthood

  • Coming to terms with your life

  • Integrity: Feel whole and satisfied with achievements

    • Meaningful life

  • Despair: Feel they have made the wrong decisions

    • Hard to accept death

Self concept

• Children younger than 15 months rarely touch their nose

• Unlike 2 year olds - recognise how they should look

• Visual self concept developed between 15-24 months

• At age 8 children define themselves based on internal, psychological attributes

• They start to think about their abilities, likes, dislikes and their personality

• Conceiving the self involves comparisons

Concepts of others

• Understanding others is a developmental process

• Infants understand social interactions are reciprocal

• By 3/4 months infants learn smiling brings playful responses

• Infants learn to read emotions

• At 12 months the infant looks at their parent for reassurance when playing

Perspective taking and thery of mind

• Perspective-taking is the ability to understand other peoples perspectives

• Involves moving our of egocentrism and representing the other persons mind in ones own

• A prerequisite to perspective taking is theory of mind

  • An implicit set of ideas about existence of mental states in oneself and others

• Appears to arise between 2-4

• Before this children struggle to understand people can hold false beliefs

• Have trouble recognising thought and reality can differ

• Theory of mind relies on normal neurological development

• ASD and ADHD associated with impairment of theory of mind

• Infants appear to understand peoples actions reflect their goals

• Infants also engage in joint visual attention when someone points

Gender Schemas

• People have turned their attention to children's knowledge

• Cross culturally children show an awareness of the cultures about gender by age 5

• By middle childhood they share common stereotypes with society

• They encode and organise information about maleness and femaleness in gender schemas

  • Mental representations that associate psychological characteristics with sex

• Technological change is reducing distinctions between sexes

• Individualistic societies hold more egalitarian sex roles

Information Processing theories on moral development

• Information-processing theories do not postule stages of moral development

• They break moral thining down into processes and examine the way they change in childhood

• People in the west tend to determine punishment according to criteria

  • The extend of damage

  • If the perpetrator has already made appropriate restitution

  • Perpetrator has suffered as a result of actions

• Understanding moral development means understanding changes in the way children answer questions

role of emotion: Psychodynamic

• This view of moral development proposed children start our narcissistic

• The begins to change with development of conscience between 2-5

• Moral development occurs through identification or internalisation

• Children take on parents value and adopt them as their own

• Guilt is the primary emotion that motivates people to obey their conscience

• Guilt arises from discrepancies between what people feel they should do and what they contemplate themselves doing

Cognitive approaches: Moral development

• The strength of cognitive social approach is its emphasis on moral/prosocial behaviour

• Thinking about morality is irrelevant if it does not affect action

• This approach assumes behaviours are prosocial and does not address situations that require choices between imperfect and mora options

• Kohlberg's theory highlights that moral development may go beyond internalisation of societies rules

• Kohlberg's theory has been critised

• People at higher stages of moral reasoning do not behave differently to people who are conventional in moral reasoning

Emotional approaches

• Morality requires self sacrifice and self-restrain

• Anxiety or guilt seems essential to balance out the net losses in gratification

• Empathy adds a source of motivational for moral behaviour

• Mothers are more responsible for moral training in most western countries

• Identification with the father not seen as central as Freud supposed

• Prosocial responses are common by 18/20 months when infants witness other peoples distress but not when they cause the distress

Health Psychology

• Is the scientific study of mental processes and behaviours that influence health and illness

• Aim to promote health, prevent and treat illness

• History of Health Psychology

  • Biopsychosocial Model

    • Biological, psychological and social factors influence health and illness

    • Treat illness or promote health must address all aspects

  • Deaths due to infectious diseases are less likely  than in the past

    • Penicillin and improved hygiene

  • Many of the current causes of death and disability in developed nations are due to lifestyle factors and are preventable

Two areas in health psychology

•  two areas in health psychology

  • Behavioural medicine

    • Treatment of illness among those already ill

  • Behavioural health/ Health Promotion

    • Promotion and maintence of health among individuals who are already healthy

Behavioural medicine

• Coping with disease disability

• Anxiety reduction for medical treatments

• Pain management

  • Experience of pain is both physiological and psychological

• Adherence to treatment

  • Patients adopts behaviours/treatment recommended by physician

Health promotion

• Road safety 

• Vaccinations

• Sun smart

• Healthy diet

• Regular exercise

• No smoking

• Drug and alcohol use

• Safe sex

• Screening

Wellbeing

• Wellbeing = Good health and positive feelings about life

  • Good mental and physical health

  • Ability to function in everyday life

  • Life satisfaction

• APS tracks wellbeing since 2011

  • Track changes and trends

• Increase wellbeing

  • Workplace changes

  • Gamification - aspects of game design to promote health

Health Belief Model

• Person might have beliefs that is against smoking but might wait until cue to action

• The health belief model suggests health behaviours are predicted by:

  • Perceived susceptibility to the health threat

  • Perceived seriousness of the health threat

  • The benefits and barriers of undertaking particular health behaviours and cues to action

Protection Motivation Theory of Health

• Self- efficacy - belief in ability to change behaviour

• Have the ability to change - self-efficacy

• People may not alter behaviour even if the threat is large

• The health model was therefore changed to include self-efficacy

  • A persons belief in their ability to undertake a particular action or behaviour

• Now model is called the protection motivation theory of health

Theory of Reasoned Action

• Look at intentions to quit smoking

• Need to look at attitudes and subjective norms

• Outcome beliefs - reduce cancer and smelling bad

  • How important is that to you? - outcome evaluation

• Subjective norms

• Perception of others views - parents want me to quit

• Desire to comply with parents

Theory of Planned Behaviour

• Added self-efficacy

• Belief about ability for change in behaviour

Transtheoretical Model

• Precontemplation - not considering changing the behaviour in near future

• Contemplation - aware problem exists and are considering taking action soon but are not yet committed to that action

• Preparation - people are preparing to make behavioural change in next month or so and are making small changes that will help them achieve their goal

• Action - lasts approx. 6 months and is when people are actively working on behavioural change

• Maintenance - people have achieved desired behaviour change and are working to maintain this

Obesity

• Excessive body fat

• BMI= kg/m2

  • Underweight = under 19

  • Acceptable = 20-24

  • Overweight = 25-29

  • Obesity = above 30

• Problems with measurement:

  • Muscle

  • Nationality

  • Age

• Waist circumference

  • Males = 94cm and higher is unhealthy

  • Females = 80cm and higher is unhealthy

• Worldwide epidemic

  • Percentage of people with BMI above 25 is increasing

• Australia

  • 2/3 of adults with BMI above 25

Obesity Consequences

• Overweight (including obesity) was the second leading risk factor (after tobacco use) contributing to ill health and death

• Overweight (including obesity) was linked to 30 diseases, including cancer, CVD, musculoskeletal conditions and type 2 diabetes

• Psychosocial:

• Increased change of

  • Low self-esteem

  • Body dissatisfaction

  • Discrimination

  • Depression

• Cognitive:

  • Lower performance on memory and word fluency tasks

Obesity Causes

• Availability of a variety of foods that are high in calories

  • Ease, convivence, and low cost of fatty foods compared to health foods

  • Motivated to east more than body requires and foods high in calories

    • Useful in competitive environments where food is not plentiful

    • Store excess in fat

  • Reduction in physical activities

    • Jobs require less excertion, cars, escalators, town planning, rise of sedentary activities - tv, video games

Food and Body Weight

• Set Point Theory

  • Weight Thermostat

    • Consistent with Drive theory

  • Deviations from set point difficult

    • When weight falls below set point

      • Increase hunger, decrease metabolic rate. Food obsession

    • When weight rises above set point

      • Huner decreases, increase metabolic rate. Food repulsion

Obesity causes Hormone

• Hormones (Leptin) may regulate weight thermostat

  • Leptin resistant = less control of weight

    • Genetic, social and environmental factors

  • Genetic Vulnerability

    • Some people more genetically prone for obesity than others

Obesity treatment

• Calorie restricting diets

  • Yo-yo effects

• Increase physical activity

  • Barriers to exercising in public

• Appetite suppressing drugs

  • Side effects

  • Decrease in self-efficacy

• Surgery (gastroplasty and gastric bypass)

  • Surgery risk

• Therapy

Cigarette smoking

• Contributors

  • Genetics

  • Environmental and social factors

• Treatment

  • Difficult to quit smoking

    • Psychological addiction (habit), physical addiction

    • Nicotine replacement, therapy, support

• Prevention

  • Costs of smoking: Taxes, ban on advertising, risk warning

  • Benefits of not smoking: school programs, advertising

Smoking nicotine

• People with 9-repeat allele gene are less likely to become smokers than people with other form of gene

• Environmental and social variables play key roles

• Main reasons people smoke include peer pressure and self-presentational concerns

• Desire to be accepted or maintain identity leads people to become hooked

• At physiological level smoking has rewarding propties

• Nicotine increased epinephrine and nopinephrine producing improved mental acuity

• Nicotine increases release of dopamine in reward centres of the brain

Treatment nicotine

• Taxes on cigarettes have made them very expensive and inaccessible

• Educational programs show hazards of smoking in schools

• Advertising campaigns to show smoke free lifestyle

• Bans on Tabaco advertising

• Smoking is now prohibited in all indoor workplaces, public places and public transport

• Nicotine replacement therapy used to curb physiological urge to smoke

Alcohol use

• Risky drinking - more than 10 standards drinks a week and or more than 4 standards on any day

• Consequences

  • 5th highest risk factor for disease

  • 60 diseases = casual link 200 diseases = contributing link

  • 2022 - 1742 deaths

• Increase injury

  • 2022 - 1900 death

• Social issues - violence

Alcohol use

• Contributing factors

  • Risky drinking

    • Social factors, cultural and environmental factors

  • Alcohol dependence

    • Withdrawal symptoms in absence of alcohol

    • Genetic factors

    • Stressors

  • Alcohol serves as a self-handicapping function

  • Self-handicapping is the process by which people set themselves up to fail

Consequences of alcohol use

• Damage to liver is one of the most obvious physiological effects to excessive alcohol consumption over time

• Alcohol is risk factor to cancer of mouth, larynx, stomach, colon and breast

• Problems with memory and reasoning can result from long term dependence

• Risk of injury of death is higher due to falls are accidents

  • Car crash, falls, drowning, burns, suicide, occupational injuries, DV

• Relationships are affected by the person who abuses alcohol

Treatment - EIMSP

• Education

• Improving community safety

• Managing availability

• Supporting people to obtain help

• Promote healthier community

• Spontaneous remission is when someone reduces alcohol intake on their own

• People with social support are likely to engage in spontous remission

• First stage of rehab is detoxification - drying out

Barriers to healthy behaviours

• Health care system

  • Cost/pricing

  • Focus on illness rather than health/prevention

  • Patient-practitioner relationship

    • Adherence to advice

  • Community and culture

    • Families and communities model behaviour

    • Education = understanding the benefits and risks

  • Self -presentation

    • Trying to manage the impressions others have of you

      • Drug taking, exercise, condom use, use of medical services, high risk behaviours, sunbathing

Individual barriers

• Lack of knowledge is rarely an explanation for people engaging in health-compromising behaviours

• Negative behaviours are rewarding - short term

• Health promoting behaviours are less enjoyable and take more discipline

• The negative effects of health compromising behaviours do not occur immediately and are always preceded by positive consequences

• Women are more likely than men to engage in preventive health behaviours and health promoting behaviours

Family barriers

• Primary models of health behaviours is parents or caregivers

• Genetics do account for part of intergenerational transmission of health habits - do not account for all

• Children emulate what their parents and older siblings model

• They see parents experience immediate reward from negative health habits they assume they will as well

Health System Barriers

• Biomedical model dominates field of medicine

• Doctors trained to focus on illness not health

• People don’t go to the doctor when well

• Encourage women to take preventative measures against breast cancer

• Health insurance prevents people from preventative health measures

• The ways doctors treat their patients is a major factor in influencing if patients follow instructions

• The doctors are overwhelmed with malpractice insurance costs and threat of lawsuit

• Patient expectations of doctors might be too high

• May become dissatisfied with doctor and quality of care

Self presentation

• Self presentation refers to people attempts to control the impressions that others form

• Can be maladaptive for health and lead individuals to engage in bad health behaviours

Stress

• Organisms response to an event (stressor) that threatens well-being and taxes coping ability

  • Threaten physical or psychological well-being (perceived or actual)

  • Long term (chronic stressor) or short term (acute stressor)

• Response

  • Behavioural, emotional, cognitive, physiological

Responses

• Emotions

  • Angry, Annoyance, Rage

  • Apprehension, Anxiety, Fear

  • Dejected, Sadness, Grief

• Cognitive

  • Lack of concentration/attention due to worry (future focused) or rumination (past focused)

• Behavioural

  • Coping - efforts to master educe or tolerate the stressful event

    • Negative: aggression, smoking, avoidance

    • Positive: Tackling the problem, seeking help

Physiological responce to stress

• Activation of the Sympathetic NS

• Fight or flight response

  • Emergency system typically activated in face of threat

    • Dilated pupils

    • Increase rate of breathing

    • Increase HR

    • Release of glucose

    • Increase blood flow to muscles

• General Adaptation Syndrome (Hans Selye)

  • Alarm Stage

    • Activation of fight or flight response

  • Resistance Stage

    • Adjust to stress

    • Body still on high alert

      • Physical arousal above normal

  • Exhaustion Stage

    • Body exhausted

    • Prone to serious disease or death

Stress and health

• Muscle Tension

  • Tension headaches, back pain

• Compromise Immune System

  • Increases susceptibility to bacterial and viral infections

• Increase the risk of chronic diseases

  • CVD, cancer, asthma attacks, stroke, ulcers

• Indirect effects on health

  • Disrupts eating, sleeping patterns, exceise, socialising

  • Can be associated with using alcohol, coffee and cigarettes

What causes stress

• Change

  • Holmes and Rahe

  • The more changes = greater stress

  • Consistent evidence that some events case stress

• However

  • Bad changes cause more stress than good changes

  • Evaluation o change is important

• Daily Hassles

  • Lazarus

  • Everyday irritations = stress

  • Change = more daily hassles

Holmes and Rahes Social Reasjustment Scale

Transactional Model of stress

• Primary appraisal - is the event stressful

  • Threat (potential for harm or loss)

  • Challenge (positive)

• Secondary appraisal - evaluate options and decides response

Personality

• Type A personality

  • Impatient, ambitious, competitiveness, hostile

    • Increase risk of CVD's

• Optimistic/Pessimistic

  • Optimistic = expect good outcomes = lower stress

  • Pessimistic = expect bad outcomes = higher stress/poorer health

    • Take less care of self

• External vs Internal locus of control (LOC)

  • Internal LOC - belief that they control their own life = lower stress

  • External LOC - belief that chance, fate or others control own life = high stress

Coping with stress

• Problem focused coping - efforts to change or remove the event causing stress

  • Problem solving, confronting, seeking support and assistance

• Emotional focussed coping - change the emotional response to the stressful event

  • Positive reappraisal, distancing, humour, denial, avoidance

    • Loosing a loved one

    • What is the good to come out of this situation

• Social support

  • People with social support cope better with stress

  • Explicit social support - seeking comfort, support or advice off others

  • Implicit social support - knowing that others are supportive

    • Western more likely to seek explicit, Eastern more likely to seek implicit

  • Either protective against harmful effects of stress or less susceptible to stress

    • Increases the functioning of immune system

Treating Stress

• Drugs - Valium

• Psychological treatment:

  • Relaxation training

    • PMR

    • Meditation

      • Mindfulness based stress reduction

    • Guided Imagery

  • Cognitive Therapy

    • Change coping style

    • Optimistic rather than pessimistic

Is stress always bad

• Stress can act as a motivator

• Inverted U hypothesis

  • Optimal performance on task under medium levels of stress

Acculrative stress

• Acculturation means coming into contact with a new dominant culture

• Acculturative stress refers to the stress people experience in trying to adapt to new culture

• Symptoms may include depression, anxiety, uncertainty and conflict

• People entering new cultures encounter language difficulties, prejudge, lower SES, and separation from family

• Immigrants face conflicts over preserving of values and beliefs and adapting new values of culture

Stress and health

• Stress can also affect memory

• Prefrontal cortex plays important role in working memory

• And hippocampus involved in long term memory

• Stress interferes with functioning of both of these

• Chronic stress leads to permeant cell death and smaller hippocampus

• Stress early in life can cause changes to children's brain structure

• Biological changes in brain can lead to mental and physical disorders, poor behaviour

• People under stress can suffer from headaches, depression, influenza

• Stress can direct effect by decreasing bodies capacity to fight illness

Stress and immune systen

• Psychoneuroimmunology examines the influence of psychosocial factors on the functioning of immune system

• The immune system detects and eliminates disease causing agents - bacteria

• B cells, T cells and natural killer cells are immune system

• B cells produce antibodies, protein molecules that attach themselves to invaders to be destroyed

• Some T cells destroy invaders

• T helper cells stimulate immune functioning - primary target of HIV

• Natural killer cells fight viruses and tumours

Coping Mechanisms

• Strategies aim at changing the situation producing stress are called problem-focused coping

• Emotion-focused coping are efforts to alter thoughts about the situation, and efforts to alter the unpleasant emotional consequences

• If a person cannot change a stressful situation directly they can change their perception

• Efforts to cope by changing the situation involve problem solving

• Coping mechanisms include active coping, suppressing competing activities, seeking out social support

Social Support

• Social support is the presence of others in whom one can confide in

• Social support is associated with protection against hypertension, herpes to cancer and heart disease

• Enhances the functioning of immune system

• Social relationships is a predictor of mortality

• Social support is associated with lower levels of PTSD and higher post-traumatic growth

• Can lead to positive, transformative changes in a persons philosophy about life

• The buffering hypothesis proposes that social support is a buffer or protective factor against harmful effects of stress

Psychological Disorders

• Psychological disorder, mental disorder or psychopathology

  • Defined as patterns of thought, emotion and behaviour that result in

    • Personal distress, or

    • A significant impairment in a persons social or occupational functioning

  • Psychopathology affects:

    • Individuals and the people whom they interact

Defining Psychological disorders

• Whether an individuals thoughts, emotions or behaviour are abnormal can be judged on 3 criterion

  • The context in which it is occurring

    • Deviance

  • The outcome associated with the behaviour

    • Distress

    • Dysfunction

Psychodynamic Perspective

• Psychodynamic theorists distinguish three classes of psychopathology that form continuum of functioning

• Neuroses are problems with living - phobias, self doubt and repetitive interpersonal problems

• Personality disorders are characterised by enduring maladaptive patterns of thought, feeling and behaviour that lead to chronic disturbances in interpersonal and occupational functioning

• People with personality disorders have difficulty maintain relationships and employment, interpret events in distorted wats

• Psychoses are gross disturbances involving a loss of touch with reality

  • Hearing voices

  • Secret service trying to kill them

• Neurotic symptoms may occur in severely disturbed individuals and psychotic states occur episodically in people who are healthy

• These levels of pathology lie on a continuum with respect to aetiology

• Psychoses result from biological abnormalities with some environment

• Neuroses and personality stem from environment interacting with biology

Cognitive Behavioural Perspective

• Cognitive-behavioural integrate an understanding of classical and operant conditioning with cognitive-social perspective

• They focus on discrete processes like thoughts that precede anxiety reaction or physiological symptoms

• Many of the problems that require treatment involve conditioned response

• Clinician assess the conditions under which symptoms such as depression and anxiety arise and tries to discover the stimulus that elicit them

• Psychopathology reflects dysfunctional cognitions like low self efficacy expectancies

Biological Approach

• Mental health professions need to move from a mental to physiological level

• Need to evaluate for potential biological contributions to symptoms

Neural Circuits

• Looks at roots of mental disorders in brains circulatory

• Normal anxiety occurs through activation of neural circuits involving amygdala and frontal lobes

• Abnormal neural firing can have genetic or environmental roots

• Biologically oriented clinicians are likely to assess carefully for family history of disorders

• Examined regions of brains of people with and without sirdooer

  • Difference in frontal and temporal lobes for people with schizophrenia

  • Frontal lobes regulate consciousness and thought and temporal lobes involved in language

• Researchers looked for evidence of neurotransmitter dysfunction in particular disorders

  • People may be overly anxious if they have to much norepinephrine

Suicide

• 75% males

• Leading cause of death for Australians aged 15-44

• Prevention

  1. Ask

  2. Listen and Stay

  3. Get help

  4. Follow up

Approaches to diagnosis

Psychodynamic:

• Neuroses (anxiety, due to environment) - personality disorders (impact on functioning, enduring state or problematic behaviour, early life experiences) - psychoses (detachment from reality, due to biological causes)

Cognitive-Behavioural:

• Learning processes; cognitive and social process

Biological:

• Neural circuits; neutransmiter dysfunction

Systems:

• Family systems - dysfunctional in context of family

• Psychological symptoms are actually dysfunctional efforts to cope with a disturbance in the family

• Family systems theorists focus on the way the family is organised - family roles, boundaries, alliances

• Family roles are the parts individuals play in repetitive family interaction patterns among family members

Biopsychosocial Model

• Considers 3 sets of factors

• Biological factors:

  • Disorders stem primarily from an underlying illness that can be diagnosed, treated and cured

  • Biological factors cause mental illness

• Psychological processes:

  • Wants, needs, emotions, attachment history

• Sociocultural contexts:

  • Gender, age, cultural values and traditions

  • Those influence what is normal

Diathesis Stress Model

• Biopsychosocial model considers a range of causal factors

• The diathesis-stress model attempts to explain how these different factors interact to create disorder

  • Genetic factors, biological processes and early life experience may combine to create a predisposition (diathesis) for a psychological disorder

• Stressful life events can then trigger the psychological disorder

• In other words, people have a differential vulnerability to developing a psychological disorder

Psychodiagnosis

• International Classification of Disease

  • Produced by WHO

  • Commonly used in Europe

• Diagnosis and Statistical Manual of Menta Disorders

  • Produced by American Psychiatric Association

  • Used in Aus

  • Current version: DSM-5-TR 2022

DSM-5-TR

• Describes abnormal patterns of thinking, emotion and behaviour that define mental disorders

• Disorders grouped by symptom characteristics and underlying vulnerability

• For each disorder specific criteria outlining the conditions that must be present before a person can be given that diagnostic label

Schizophrenia

• Lifetime prevalence = 1%

• Similar prevalence in males and females

• Early onset

• Only 10-20% fully recover

• Hospitalisation

• Risk of suicide

Positive Symptoms

• Delusions and irrational thought

  • Defining features

  • Delusional thinking

    • False beliefs that are maintained even though they are clearly out of touch with reality

    • Delusions of grandeur

  • Loosening of associations

    • Disjoined thought

• Hallucinations

  • Sensory perceptions that occur in the absence of a real, external stimulus or are gross distortions of perceptual input

  • Auditory hallucinations most common

    • Insults

    • Running commentary

    • Instructions

Negative Symptoms

• Disturbed emotion

  • Blunted or flat affect

  • Inappropriate responses

  • Emotionally volatile

• Catatonic behaviour

  • Motor disturbance

  • Rigid (catatonic stupor)

  • Random activity (catatonic excitement)

Etiology of Schizophrenia

• Genetic Vulnerability

• Neurochemical abnormality

  • Dopamine hypothesis

    • Excess dopamine

• Diathesis-stress model

  • Genetic vulnerability + environmental stress

    • Hostile parenting

    • Child abuse

    • Trauma

• Neurodevelopmental Hypothesis

  • Disruption in maturation process before or at birth

    • Increases vulnerability

    • Viral infections or malnutrition

    • Influenza epidemic

    • Famine during WW2

    • Birth complications

      • Prolonged labour or deprivation of oxygen

Bipolar Disorder

• Depression and manic episodes

• Only one manic episode needed

  • Euphoria, elation, hyperactive, tireless, increased appetite, talkative, self-confidence, increase in self-esteem

• Early Onset

  • 1 in 50 Australians diagnosed a year

  • 3 x greater prevalence in women

  • Suicide risk

Major Depressive Disorder

• Subjective judgment required to determine whether mood is more extreme that normal unhappiness

  • Duration

    • Persistent feelings of sadness and despair and a loss of interest in previous sources of pleasure

    • Impact on functioning

  • Anhedonia: Reduced ability to feel pleasure

    • Lack motivation

    • Lack energy

  • Change in eating, reduction in self-esteem, hopelessness, co-morbidity

• Prevalence = 6.2%

  • Present but less prevalent in children and adolescents

  • Higher prevalence in Indigenous populations, rural and females

  • Risk of suicide

Etiology of Depressive Disorders

• Heredity may be linked to neurochemical abnormalities

  • Low levels of neurotransmitters

    • Norepinephrine

    • Serotonin

  • Anti-depressant medication increase levels of these neurotransmitters

• Cognitive

  • Learned helplessness

  • Give up in the face of negative events

  • Pessimistic explanatory style: Internal, stable and global attributions

• Cognitive distortions

  • Transform neutral or positive information

  • Magnification and minimization

  • Over generalisation

Specific phobia

• High anxiety and irrational fear related to a specific object or situation

  • Must interfere with everyday functioning

• Trembling and palpitations are common

• Can relate to anything - spiders, feathers, flying

Genrealised Anxiety Disorder

• High anxiety not related to a specific threat

• Worry about mistakes and problems - family, money, work

• Prevents major negative events

• Trembling, diarrhoea, dizziness

• Prevalence = 2%

Panic Disorder and Agoraphobia

• Panic disorder: Unexpected anxiety attacks

  • Concerned about their next attack

  • Late adolescence or early adulthood

  • Female

• Agoraphobia: Fear of public places

  • May not want to leave home

  • May be related to fear of having another panic disorder

Etiology of Anxiety Disorders

• Learning

  • Classical: Neutral stimulus paired with negative event

  • Operant conditioning: Avoidance of stimulus

  • Evolution: Preparedness suggest people are able to acquire fears

    • Snakes and spiders

  • Limitations:

    • Many do not remember the first event

    • Can be learned vicariously

• Cognitive:

  • Thinking styles

    • Misinterpretation of situations

    • Attend to threats

    • Selective recall

    • "the doctor examined little Emmas growth"

  • Stress

    • Disorders can follow from stressful experiences

OCD

• Persistent, uncontrollable intrusions of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions)

  • Impair functioning

  • Early onset

  • Obsessions: Intrusive thoughts

  • Compulsions: Actions

    • Rituals

Etiology of OCD

• Etiology: interaction between biological and psychological factors

• Aspects of OCD may overlap with other disorders - feeding and eating disorders

• Biological:

  • Serotonin deficiency

PTSD

• Severe anxiety associated with major trauma

• War veterans

• Also

  • Rape

  • Car accident

  • Natural disaster

• Re-experieing trauma, hallucinations, increased arousal

• Intensity of reactions towards the event is a predictor

• Lifetime prevalence: 12%

• Higher in front line professions

Dissociative Disorders

• Lose contact with portions of their consciousness or memory, resulting in disruptions in their sense of identity

• Dissociative Amnesia and Fugue

  • Memory deficits

• Dissociative amnesia: Loss of personal information

  • Individual traumatic event or time around this event

• Dissociative fugue: loss of entire personal memory and personal identity

  • Retain other memories - driving a car, playing golf

Dissociative Identity Disorder

• Co-occurrence of two or more distinct personalities

• Multiple identities

  • Own name

  • Memories

  • Characteristics

  • Unaware of the other existence

• History of anxiety disorders

• Female

• Increase in diagnosis between 70s-90s

Etiology of Dissoaciative Disorders

• History of extreme trauma - sexual abuse

• Little genetic influence

• Majority of cases female

Feeding and eating disorders

• Severe disturbance in eating behaviour

  • Anorexia nervosa

  • Bulimia nervosa

  • Pica - eat things that are not edible

  • Avoidant-restrictive food intake disorder - extreme fussy eating

  • Binge eating disorder - overeating

• Lifetime prevalence 8.4% females, 2.2% males

Anorexia nervosa

• 3% of those with an eating disorder

• 10x more prevalent in females

• Self-starvation, self-induced vomiting, excessive exercise and laxative use

• Body weight below 85% of normal

• Serious permanent health consequences - including morality

Etiology of Anorexia Nervosa

• Complex aetiology

  • Genetic factors

  • Biological factors - hormone

  • Social influences

  • Personality factors

  • Cultural pressures to be thin

Bulimia Nervosa

• 12% of people with eating disorders

• 70% female

• Person may be thin, normal or overweight

• Binge-purge episodes

• Non-life threatening health consequences

• Complex aetiology including personality factors, low self-esteem, stress, depression and cultural pressures to be thin

Personality Disorders

• Defied as long standing, inflexible ways of behaving that create a variety of problems

• DSM-5-TR defines 10 personality disorders

• 10-12% prevalence

•