PY0421 Lecture 1 - Intro & Background_WITH ANSWERS

BACKGROUND & CORE CONCEPTS

• Introduction by Dale Metcalfe

AIMS

• Introduce mental health and mental illness

• Explain how diagnosis is made

• Introduce aetiology paradigms

• Explain what is meant by epidemiology

• Introduce treatments and prognosis

MENTAL HEALTH VS ILLNESS

What is Mental Health?

• Defined as a state of wellbeing, not just happiness.

• Involves the ability to:

  • Engage in productive activities

  • Avoid destructive activities

  • Make positive contributions

  • Foster fulfilling relationships

  • Adapt to stressful situations

• Can experience mental health problems including:

  • Mood fluctuations

  • Feelings of anxiety

  • Trouble sleeping

What is Mental Illness?

• A medically diagnosable condition that significantly:

  • Impairs cognitive abilities

  • Impairs affective abilities

  • Impairs relational abilities

• Optimal mental health can occur with or without mental illness.

• People may maintain good mental health while experiencing mental illness, or have poor mental health without it.

MYTHS ABOUT MENTAL ILLNESS

False Beliefs

• Mental illness only affects others:

  • Approximately 25% of people experience mental health problems annually.

• Mental illness is permanent:

  • Some have a single episode, periodic episodes, or experience it rarely.

• Stigma is a thing of the past:

  • While diagnostic labels can provide explanations and reduce stigma, stigma persists.

WHAT WE KNOW ABOUT MENTAL ILLNESS?

Key Questions

• Symptoms and clinical presentation allow for assessment and diagnosis.

• Aetiology refers to the causes of mental illness.

• Epidemiology studies how common mental illnesses are and who is affected.

• Treatment approaches and recovery possibilities vary based on individual cases.

• Prognosis relates to potential outcomes and expectations for recovery.

SYMPTOMATOLOGY AND DIAGNOSIS

Clinical Presentation

• Symptoms reported by patients and directly observable signs.

• Assessment through:

  • Self-reports

  • Interviews

  • Physiological measures (like anxiety)

  • Cognitive assessments (like attention span)

Key Features of Symptoms

• Causes distress and impair functioning in:

  • Psychological

  • Social

  • Physical

  • Occupational areas.

• Changes in:

  • Affect (mood and emotion)

  • Behaviour (sleep, eating, hygiene)

  • Cognition (flexibility, memory, concentration)

HOW TO DIAGNOSE PSYCHOLOGICAL CONDITIONS

• Psychological diagnoses rely on distinct signs/symptoms.

• Systems used in diagnosing include:

  • DSM-5 (Diagnostic and Statistical Manual of Mental Disorders)

  • ICD-11 (International Classification of Diseases)

HOW TRUSTWORTHY IS A DIAGNOSIS?

Validity and Reliability

• Validity: Accuracy of the diagnosis improves with distinctness between disorders.

• Reliability: Consistency of diagnosis over time:

  • Inter-rater reliability: Agreement between clinicians

  • Intra-rater reliability: Consistency in applying diagnostic categories.

• Standardisation improves reliability using consistent tests and interview processes.

CO-MORBIDITY

• Definition: Occurrence of two or more conditions in an individual.

• Reliability is generally acceptable, but validity can suffer from overlapping symptoms; incorrect diagnoses risk ineffective treatments.

AETIOLOGY: THE CAUSES

• Categorized into biological, psychological, and social paradigms:

  • Biological: Genetic, evolutionary, neuroscientific paradigms.

  • Psychological: Cognitive-behavioral paradigm.

  • Other: Personality theories, humanistic approaches, and social influence.

  • Integration of many paradigms into an overall biopsychosocial model.

BIOLOGY: GENETIC PARADIGM

• Many psychological characteristics are partly heritable.

• Heritability refers to the variability in a phenotype due to genetics in a population.

• Example: Height's heritability is about 90% in males, indicating significant genetic influence over environmental factors.

CONCORDANCE RATES

Studying Heritability

• Examines the likelihood of shared characteristics within families.

• Uses studies on twins and adoptions to analyze gene-environment interactions.

  • Monozygotic (identical) twins share 100% of genes; dizygotic (fraternal) share 50%.

BIOLOGY: EVOLUTIONARY PARADIGM

• Focus on evolution of the mind through natural selection principles.

• Examines the adaptive advantages of psychological conditions that may have existed.

BIOLOGY: NEUROSCIENTIFIC PARADIGM

• Studies neurotransmitter function and brain structure:

  • Neurotransmitters include serotonin, dopamine, norepinephrine, and GABA.

  • Analyzes effects of brain imaging and injuries on mental health.

COGNITIVE BEHAVIOURAL PARADIGM

• Cognitive aspects involve:

  • Attention

  • Schemas and cognitive distortions.

• Behavioral elements include:

  • How behaviour is learned: classical conditioning, operant conditioning, and modeling.

OTHER AETIOLOGICAL APPROACHES

Diverse Influences

• Personality factors evaluated through psychodynamic, humanistic, and social lenses.

• Impact of stressful life events and family dynamics on mental health.

DIATHESIS-STRESS MODEL

• Integrative model accounting for risk factors:

  • Biological: Genes, biochemical disorders

  • Social: Environmental stressors

  • Psychological: Cognitive conflicts

• Examines the combination of stressors leading to disorders.

EPIDEMIOLOGY

• Studies demographics surrounding mental illness:

  • Incidence and rates of diagnosis

  • Age of onset and gender differences

  • Duration from onset to diagnosis

  • Regional variations in mental health prevalence.

INTERVENTION: APPROACHES TO TREATMENT

• Treatment linked back to aetiology - knowledge of cause informs treatment direction:

  • Biological: Psychoactive medications to target neurotransmitter function.

  • Psychological: Various therapy types based on different models (psychodynamic, humanistic, cognitive).

  • Integrative approaches combine various therapeutic strategies for holistic treatment.

PROGNOSIS: OUTCOMES

Key Considerations

• Difference between recovery (symptoms absent and functional return) and cure.

• Factors influencing prognosis include:

  • Age at onset

  • Promptness of diagnosis and treatment

  • Social support systems.

  • Treatment compliance.

  • Co-morbidity and motivation levels.

PROGNOSTIC CONSIDERATIONS

• Evaluates recovery and treatment choices.

• Motivations of patients and the significance of diagnoses.

• Recognizes the potential for stigma related to mental illness labels and how proper understanding can alleviate stigma.

YOU SHOULD NOW KNOW

• Key differences between mental health and mental illness.

• What the DSM-5 entails and its main criticisms.

• Understanding different types of reliability in diagnosis.

• Definitions of aetiology, epidemiology, treatment, and prognosis.

THE TASK THIS WEEK

• Familiarize with BlackBoard resources.

• Review module handbook and reading list.

• Explore Community Care website for current mental health developments.