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Understanding human diversity > Lecture week 10 - Mental health > Flashcards

Lecture week 10 - Mental health Flashcards

1
Q

mental health variously conceptualised as…

A

– a positive emotion (e.g., happiness),
– a personality trait including the psychological
resources of self-esteem and mastery, and
– as resilience (the capacity to cope with adversity)

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2
Q

WHO 2004 definition of mental health

A

“…a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community” (p. 12)

  • mental health is more than the absence of mental illness
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3
Q

the presence of mental health does not imply what?

A

the absence of mental health

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4
Q

the absence of mental illness does not imply what?

A

the presence of mental health

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5
Q

the absence of mental illness does not imply what?

A

the presence of mental health

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6
Q

mental health as a complete state can be seen as what?

A

a dual dimension (scales of mental health and mental illness crossing each other)

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7
Q

subjective wellbeing (SWB)

A

the extent to which people think and feel that their lives are going well; aka happiness

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8
Q

SWB is often seen as constituted by what?

A

a cognitive component and an affective component (e.g., Tov & Diener, 2013):
– cognitive (reflective) judgement – an individual’s judgment that their life is going well, aka life satisfaction
“If I could live my life over, I would change almost nothing.”
– affective experience – positive and negative affect (emotions) individuals experience as they live their life
“Indicate to what extent you have felt XXX during the past few weeks”

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9
Q

factors influencing SWB

A

– Basic needs (food, safety, shelter, meaningful relationships)
– Psychological needs (competence, autonomy, freedom)
– Personality
– Age, gender, ethnicity, education, employment status, income, religiosity/spirituality…

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10
Q

who says personality is an important factor in SWB?

A

Lucas and Diener 2009

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11
Q

evidence supporting point that SWB is effected by personality

A

– SWB is moderately heritable (~ 40-50%)
– SWB is moderately stable over time (“setpoint level of happiness”),
though major life events may have large and lasting effects
– SWB has been linked to specific personality traits
– SWB’s correlations with personality traits tend to be much larger than correlations with demographic predictors/life circumstances

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12
Q

which two of the big 5 traits are critical for SWB?

A

extraversion and neuroticism

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13
Q

types of theories linking personality and SWB

A

instrumental theories and temperament theories

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14
Q

instrumental theories and how they associate personality with SWB

A

personality indirectly affects SWB by influencing choice of situations or the experience of life events (McCrae & Costa, 1991)
– E.g., extroverts may participate and enjoy social activities, which may in turn affect the amount of positive affect that they experience

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15
Q

temperament theories and how they associate personality with SWB

A

there is a direct personality to SWB link (e.g., Larsen & Ketelaar, 1991)
– E.g., extroverts respond with more positive emotion to signals of reward; neurotics respond with more negative affect to signals of punishment

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16
Q

mental disorders are diagnosed using what?

A

– Diagnostic and Statistical Manual of Mental Disorders –
5th Edition (DSM-5) or
– International Classification of Diseases, 10th/11th Edition
(ICD-10,ICD-11)

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17
Q

DSM-5 defines mental disorder as what?

A

“A syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or development processes underlying mental functioning”

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18
Q

what did the WHO world mental health survey initiative find (Kessler et al., 2007)

A
  • Anxiety disorders, mood disorders, impulse control disorders, substance use disorders; 17 countries
  • Typical onset and prevalence of each individual disorder vary greatly
  • Lifetime prevalence of having one or more of the disorders ranged from 47.4% in the United States to 12.0% in Nigeria
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19
Q

what is similar about the DSM and the ICD

A

both use a set of diagnostic criteria to determine the presence or absence of specific behaviours/ characteristics that are considered key for a specific disorder, e.g.,
– symptoms, symptom severity – onset
– stability
– impact on functioning

All or nothing principle (an individual either has or does not have a disorder)

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20
Q

criteria used by the DSM and ICD include what?

A

– symptoms, symptom severity (mild or strong episode?)
– onset (if onset isn’t in early childhood another problem may be present)
– stability (a few days or a long time? sometimes has to be at least 6 months)
– impact on functioning (if a person isn’t impacted enough then a diagnosis isn’t likely to be made)

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21
Q

cluster A personality disorders

A

odd/eccentric type

paranoid - suspicious interpretation of other’s
schizotypal - social discomfort. cognitive distortions
schizoid - social detachment and restricted emotional expression

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22
Q

cluster B personality disorders

A

dramatic/erratic type

antisocial - disregard for others rights
narcissistic - need for admiration, lack of empathy
histrionic - excessive emotionality and attention seeking
borderline - unstable relationships, impulsivity

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23
Q

cluster C personality disorders

A

anxious/fearful type

avoidant - social inhibition and sense of inadequacy
dependent - submissive, need to be taken care of
obsessive-compulsive - preoccupation with orderliness, perfectionism and control

24
Q

DSM-5 criteria for personality disorders

A

For all personality disorders, the following six criteria must be fulfilled:
1. Enduring, maladaptive patterns of behaviours and cognitions that deviate markedly from what is expected and accepted
2. The enduring pattern is inflexible
3. It leads to significant distress or impairment in functioning
4. The pattern is stable and can be traced back to adolescence or early childhood
5. Exclusion of other mental disorders/comorbid disorders
6. Exclusion of alternative causes such as physiological effects of a substance or another medical condition

25
Q

DSM-5 criteria for narcissistic personality disorder

A

At least five of the following nine criteria must be fulfilled:
1. A grandiose sense of self-importance
2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
3. Believing that they are “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
4. Requiring excessive admiration
5. A sense of entitlement (unreasonable expectations of especially favourable treatment or automatic compliance with their expectations)
6. Being interpersonally exploitative (taking advantage of others to achieve their own ends)
7. Lacking empathy (unwilling to recognise or identify with the feelings and needs of others)
8. Often being envious of others or believing that others are envious of them
9. Showing arrogant, haughty behaviours or attitudes

25
Q

DSM-5 criteria for narcissistic personality disorder

A

At least five of the following nine criteria must be fulfilled:
1. A grandiose sense of self-importance
2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
3. Believing that they are “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
4. Requiring excessive admiration
5. A sense of entitlement (unreasonable expectations of especially favourable treatment or automatic compliance with their expectations)
6. Being interpersonally exploitative (taking advantage of others to achieve their own ends)
7. Lacking empathy (unwilling to recognise or identify with the feelings and needs of others)
8. Often being envious of others or believing that others are envious of them
9. Showing arrogant, haughty behaviours or attitudes

26
Q

DSM-5 criteria for borderline personality disorder

A

At least five of the following nine criteria must be fulfilled:
1. fearofabandonment
2. unstableorchangingrelationships
3. unstableself-image,includingstruggleswithsenseofselfandidentity
4. stress-relatedparanoia
5. angerregulationproblems,includingfrequentlossoftemperorphysicalfights
6. consistentandconstantfeelingsofsadnessorworthlessness
7. self-injury, suicidal ideation, or suicidal behaviour
8. frequentmoodswings
9. impulsivebehaviourssuchasunsafesex,recklessdriving,bingeeating,
substance abuse, or excessive spending

27
Q

diathesis-stress model to explain mental disorders

A

posits that mental disorders result
from an interaction between inherent vulnerability and environmental stressors
– the greater an individual’s vulnerability to a mental disorder, the smaller the amount of stress needed to trigger the development of the disorder
– can help to explain why some individuals develop a disorder while others do not
– e.g., effects of Covid on mental health and wellbeing (e.g., Hossain et al., 2020)

28
Q

what makes somebody vulnerable?

A

risk (and protective) factors

e.g. genetic, biological, family-related, society

29
Q

cognitive epidemiology

A

study of the links between intellectual abilities and health and disease

30
Q

intelligence as a risk/protective factor

A

– intelligence in early adulthood predicts hospitalisation for (all) mental
disorders and with illness severity (Gale et al., 2010)
– high childhood intelligence lowers risk of subsequent development of schizophrenia (e.g., Dickson et al., 2012), depression (e.g., Johnson
et al., 2011), and Alzheimer’s disease (Anderson et al., 2020)

31
Q

evidence that high intelligence is a risk factor for mental illness

A
  • Karpinski et al. (2018) show a heightened prevalence of mental disorders in high-IQ individuals
  • Sample: members of American Mensa Ltd, a “high IQ society” in the US (N = 3715), who scored in the top 2% on an IQ test
  • Hyper Brain/Hyper Body framework
32
Q

hyper brain/hyper body framework explanation

A

individuals with a high IQ may be overexcited, worry a lot, might ruminate a lot which are risk factors for mental disorders

33
Q

evidence against the idea that high intelligence is linked with mental illness

A

Caution 1: the findings of Karpinski et al. (2018) are correlational
– E.g., people preoccupied with intellectual pursuits may spend less time than the average person on physical exercise and social interaction, both of which have been shown to have broad benefits for psychological/physical health.
* Caution 2: sampling bias (who takes an IQ test and wants to join Mensa?)
* Williams et al. (2022, preprint): data from the UK Biobank
– Compared high (+2 SD above the mean; N=16,137) vs. average IQ group (within +/-
2SD around the mean; N=236,273)
– High IQ individuals were less likely to have general anxiety and PTSD, were less
neurotic, and were no more likely to have any other mental disorder

34
Q

4 models linking personality and mental disorders

A

scar-complication model
vulnerability-risk model
pathoplasty model
spectrum model

35
Q

scar-complication model

A

mental disorders may lead to changes in premorbid personality

36
Q

vulnerability-risk model

A

specific personality traits put an individual at risk of developing a particular mental disorder

37
Q

pathoplasty model

A

personality traits modify the presentation, course and severity of mental disorders

38
Q

spectrum model

A

personality and mental disorders are part of the same continuum

39
Q

study as evidence for personality as a risk/protective factor for mental disorders

A

(Meta analysis; Malouff et al., 2005)

– similar pattern of associations across many disorders (e.g., substance use,
schizophrenia, anxiety/eating disorders): high Neuroticism, low Conscientiousness, low Agreeableness, and low Extraversion
– child externalising disorders: low Neuroticism, low Agreeableness, high Extraversion
– mood disorders: lower Extraversion level compared to the other disorders

40
Q

how does personality predict support seeking?

A

– high Neuroticism predicts depression treatment use (Hengartner et al., 2016)

41
Q

evidence that personality is relevant for illness behaviour/recovery

A

– high neuroticism and low conscientiousness are associated with non- compliance (Umaki et al., 2012)
– if the personality disorder is ego-syntonic (e.g., Antisocial and Narcissistic) it may be hard to engage the patient in treatment
* may difficulty maintaining relationship with therapist
* may rarely be present for treatment (e.g. Antisocial PD)

42
Q

childhood factors as risk factors for mental disorders

A
  • childhood physical, emotional, and sexual abuse is associated with all PDs (Rettew et al., 2003)
  • low levels of parental affection or nurturing were associated with a higher risk of antisocial PD (Johnson et al., 2006)
  • higher levels of abuse, neglect, instability in environment, and paternal psychopathology associated with borderline PD (Helgeland & Torgersen, 2004)
43
Q

are personality disorders distinct from other mental disorders or is there comorbidity?

A

– Cluster A PDs could be seen as a mild and persistent form of psychotic disorders
– Cluster C PDs and anxiety disorders overlap considerably rather than being distinct

44
Q

proposal for a dimensional model to explain personality disorders - evidence

A

– considers various personality features along several continuous dimensions (e.g., the dimensions of the FFM)
– DSM PDs “are readily understood as maladaptive variants of the domains and facets of the FFM” (Widiger & Mullins-Sweatt, 2009; p. 199)
– A multi-dimensional personality profile is clinically less straightforward than a diagnostic label

45
Q

emotion regulation

A

set of strategies that individuals may use to increase, maintain, or decrease their emotional experience

46
Q

emotion regulation as a risk/protective factor (Aldao et al., 2010)

A

– emotion-regulation strategies associated with various mental disorders (i.e.,
anxiety, depression, substance abuse, eating disorders)
– maladaptive strategies (rumination, avoidance, suppression) were associated
with more and adaptive strategies (acceptance, reappraisal, problem solving) with less psychopathology

47
Q

many mental disorders are said to be characterised by problems with what?

A

emotion and emotion regulation (Gross & Jazaieri, 2014)

48
Q

individuals with mental disorders may have problems with what?

A

– emotional intensity
– emotion duration
– emotion frequency
– emotion type

49
Q

what disorder has problems with emotional awareness?

A

panic disorder

50
Q

what disorder has problems with emotion-regulation goals?

A

bipolar disorder

51
Q

what disorder has problems with emotion-regulation strategies?

A

agorophobia

52
Q

what is dialectical behaviour therapy the most effective treatment for?

A

borderline personality disorder

53
Q

what does dialectical behaviour therapy encourage?

A

the balance of both acceptance and change

54
Q

one potential mechanism of change in dialectical behaviour therapy

A

he reduction of ineffective action tendencies linked with dysregulated emotions (Linehan et al., 2006)
– Learning how to understand and name emotions; mindfulness
– Changing unwanted emotions
– Reducing vulnerability: accumulate positive emotions & coping
mechanisms
– Managing extreme situations

Understanding human diversity (11 decks)

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