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PYSCH 2B > Week 7/8 Psych Health > Flashcards

Week 7/8 Psych Health Flashcards

1
Q

what are psych health problems

A

experiences/emotions/perceptions/judgements/thoughts/sensations/urgers/motivations/behaviours
–> that cause distress to self/others

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2
Q

positive effects of receiving a diagnosis

A

can make sense
reduce self-blame
access services
find supprot

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3
Q

negative effects of receiving a diagnosis

A

stigma
sense of different
defeat
may feel trapped

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4
Q

abnormal?

A

psych health problems = recurring patterns of human experience
not statistically/qualitatively abnormal
‘abnormal’ = biomedical view
stigmatising

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5
Q

diagnostic classification

A

based on recurring and reliable patterns of human experiences
categorises + classifies them into discrete entities called ‘diagnoses’ of ‘disorder’

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6
Q

aims of classification systems

A

reliability
underlying assumption: having such ssstems furthers understanding mechanism + cause –> treatment

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7
Q

classification systems

A

diagnostic + statistical manual of mental disorders (DSM5)
international classification of diseases - 11th

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8
Q

major depressive disorder symptoms

A

experiece 5+ symptoms during 2-week period: 1) depressed and/or 2) loss of interest
all most of day, every day
- depressed mood
- diminished interest in all activities
- weight loss when not dieting/weight gain/appetite changes
- thought has slowed + physical movement decreased
- fatigue/low energy
- feeling worthless/inappropriate guilt
- diminished concentration/indecisiveness
- thoughts of death/suicidal ideation/suicide attempt
- impairment in social, occupational, functional areas
- not resulting from substance abuse/medical condition/bereavement

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9
Q

diagnostic system criticisms

A
  • dont known if diagnoses are discrete things
  • no confirmation tests
  • ultra-common comorbidity
  • diagnostic differences among clinicians
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10
Q

dsm5 critiques - scientific, practical, ethical

A
  • lack of validity - based on consensus about clusters of clinical symptoms (not objective laboratory measure)
  • minor changes to criteria = big diff in diagnostic rates
  • diagnoses have proliferated but arbitrary deletions too
  • DSM book = income stream for APA
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11
Q

psychological formulation

A

use existing psycho knowledge to understand origins/mechanisms/maintenance of individual problems

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12
Q

five p’s formulation

A

predisposing + precipitating + perpetuating + protective factors = presentation or problem

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13
Q

theory-specific formulation

A

harder to integrate various elements
can be more precise
can be linked more to specific evidence-based practice
can be limited by diagnosis, blind-spots in theory
can straddle diagnoses

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14
Q

CBT formulation

A

early life events
core beliefs
conditional assumptions
critical incident activates negative auto responses
behaviour + physiological + emotions interact with each-other and negative responses

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15
Q

using formulation for intervention

A
  • built collaboratively over time with person
  • not imposed, instead explained, encouraged
    put meaning
  • put meaning/understaanding into problems
  • highlight places to intervene in therapy
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16
Q

macrolevel influences

A

poverty
social exclusion
discrimination
multiply discriminated identities

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17
Q

poverty stigma and social exclusion

A

negative perceptions
stereotypes abound
stigma can be internalised
childhood poverty damaging
intergenerational transmission of poverty

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18
Q

large-scale factors require

A

policy
influence
advocacy
campaigning work

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19
Q

intrapersonal influences on psych processes

A

personal historical factors
cog factors
behavioural factors

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20
Q

cognitive processes distorted in psychopathologies

A

info processing distortions along the chain
selective attention - threat stimuli in anxiety
memory - neg self-rated info in depression
overly general memory - depression
absence of selective in anxiety
interpretation - selective
cog products - intrusive repetitive thinking
inhibition - difficulties with control

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21
Q

general processes (4)

A

unprocessed memory intrusions
formation of neg expectancies and self-beliefs
disruption of dev pathways + social bonds

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22
Q

behavioural processes

A

classical: avoidance, escape create habituation, prevents extinction
safety behaviours: mixed evidence

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23
Q

interpersonal influences on psychopathology

A

attachment: insecure = avoidant, disorganised, ambivalent (strange situation test)
family dynamics
peer groups
leadership figures
social support
alienation

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24
Q

insecure attachment

A

general risk for poor psych health
childhood sep anxiety
pathological grief
personality disorders:
- anxious attachment = emotional dysregulation
- avoidant attachment = avoidant, inhibited personality
requires interplay with other factors

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25
Q

factors influencing a negative family emotional climate

A

high negative emotional expression
poorly managed parental emotion
psychologically controlling behaviours
little warmth/positivity, much criticism

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26
Q

cumulative risk factors for child psychological health problems (5)

A

40% parenting practices
20% parental verbal conflict, mood problems
15% disturbed, antisocial parental behaviour
10% instability, adverse life events
0% family structure, SES

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27
Q

social support buffering hypothesis

A

stressor
–> appraisal (support prevent negative appraisal)
–> response (support facilitate reappraisal, maladaptive response inhibition / inspire adaptive responses)
–> expression in symptoms/behaviour

28
Q

offsetting mechanism

A

perceived stigma of psych health diagnosis –> neg mental health –> social support –> pos psych health

29
Q

4 positive psych interventions

A
  • expressing gratitude
  • acts of kindness
  • smiling
  • meditations
30
Q

4 areas that are pathways to flourishing

A

wellbeing
quality of life
good health
life meaning

31
Q

issues with the concept of ‘flourishing’

A

very broad
measurement problems
contradictions
lack of critical thinking
implicit value judgements

32
Q

means of attaining ‘balanced’ positive psychology

A

avoid extremes
develop complementarity among areas
temper construct definitions
require contextual sensitivity
acknowledge both: conscious, unconscious phenomena

33
Q

more positivity in CBT

A

less focus on symptom reduction
more focus on building adaptive behaviours
retraining maladaptive processes
train positive approaches e.g. self-acceptance + compassion

34
Q

compassionate mind training

A

based on paul gilbert
highly shame-prone, self-critical people
trains, cultivates soothing stance towards self
buddhist conceptualization

35
Q

3 systems in compassion focused therapy

A

threat
drive
soothing

36
Q

psych flexibility + acceptance and commitment therapy

A

updated form of CBT
emphasises accepting unpleasant thoughts + letting them go
articulates personal values
garners commitment to actions
teaches ‘open, aware, engaged’ responses

37
Q

the power threat meaning framework

A

brings together macro factors
brought into useable explanatory framework
proposed as alt to diagnostic classification

38
Q

questions in the power threat meaning framework

A

what role did power play
what kind of threats did this pose
what meanings did/do these experiences have for you
what kinds of response are you using
what access to power resources do you have

39
Q

case: marko

A

early forties, eastern european, happily married, young child, labourer in construction
–> arrived in UK as refugee
- war experiences:
- ethnic crime + attempted genocide experiences
- held in internment camp (beaten, malnourished)
–> after liberation = reunited with family + another child
- marko not working due to poor psych health
(neighbourhood harassment, kept within refugee community)

40
Q

marko presentation of psychopathology

A

flat mood
poor motivation
frequent panic attacks
no sense of future
some suicidal thoughts

41
Q

how has power affected marko’s life

A

state violence against his ethnic group
forced removal from home
daily abuse
forced refugee status
ethnic minority in UK
harassment
unemployment, social stigma + exclusion

42
Q

what did the power that affected marko do to him?

A

robbed of security, identity sources: work, community, family, culture, fun

43
Q

marko threat response

A

hypervigilant
startled
nightmares
anxious/angry/frustrated
feeling unwelcome and afraid

44
Q

what sense did marko make of his life

A

cant trust
people are evil
could not protect family
cant see future life + supporting family
refugee paradox: grateful for safety + resent dependency

45
Q

what is marko doing to survive

A

numb feelings, avoid past
avoid news
ashamed - dont talk to others

46
Q

what are marko’s strengths

A

wife, family very supportive
loving, caring father
aware of social injustice

47
Q

how can marko’s story be integrated?

A

symptoms = responses to repeated trauma + systematic powerlessness + destruction of life

marginalization in UK made adaption more difficult

foreshortened future sense + numbing = rational ways of dampening intense fear

48
Q

how was marko helped

A

not PTM based treatment
cog therapy/exposure to build understanding of trauma

49
Q

classical trauma bind

A

traumatic events
–> extreme threat appraisals
–> fear activated
–> avoids cues, stimuli
–> memories, event narratives unprocessed
–> intrusions i.e. nightmares/flashbacks trigger cycle

50
Q

early sessions for marko

A

found it hard to talk
more fearful
more intrusions
trusted consultant: felt more comfortable: revealed more
–> expressing anger at injustices

51
Q

mid sessions for marko

A

understood numbing was coping mechanism
understood his hopelessness + disconnection + not going outside = avoiding further loss
BUT costing connections with his children + wife + dev. of his own life

52
Q

later sessions for marko

A

find courage to risk /experiment again
went out more
talked to wife more
encouraged others in community to talk about experiences
started to come to terms with his trauma
recognised UK must be his home

53
Q

power threat meaning marko

A

needed safe place to express rage at injustices
needed to acknowledge feelings of marginalization as refugee
–> realisation of his disonnection from UK society was perpetuating that
–> allowed refugee paradox to be contained
–> understood numbing was trapping him in his history

54
Q

conclusions about marko

A
  • work consistent with PTM framework
  • outlined mechanisms at work in his situation
  • narrative and meaning making helped
  • consultant guided by PTM type model of trauma: acknowledge exposure, reduce avoidance of further threat, adaptive narrative of meaning
  • underlying mechanisms linked to DSMV - defined disorder PTSD
55
Q

definitions of disorders and underlying mechanisms

A
  • definitions of disorders have articulated mechanisms –> models
  • model of mechanisms = useful
  • conceptualizing mechanisms aids understanding but intervention optimally ultimately individual
56
Q

definition of psych flexibility

A

human abilities to:
adapt to situational demands
shift mindsets/behaviour
maintain balance among life domains
be committed to behaviours congruent with values

57
Q

diff between psych flexibility and acceptance commitment therapy ACT

A

flexibility generalised behavioural response style
- all adaptive human functioning

ACT transdiagnostic, non-diagnostic
- theoretical clinical model articulates it

58
Q

outline of the ACT model

A

6 interdependent processes
called ‘hexaflex’

59
Q

outline of ACT inflexibility model

A
  • dominance of past/future
  • lack of clarity with values
  • lack of effective action
  • attachment to a self-story
  • cognitive fusion
  • experiential avoidance
60
Q

outline of ACT flexibility model

A

open:
willingness/acceptance
cog defusion

engaged:
contact with present moment
flexible perspective about ‘stories’

aware:
clarity with values
committed actions towards values

61
Q

ways to increase awareness

A

mindfulness meditation
daily diary tracking psych flexibility
pay attention while multitasking

62
Q

ways to increase openness

A

acknowledge + validate experiences
sing difficult thoughts
say them in a funny voice

63
Q

uncertainty of recovery from psych health disorder diagnoses

A

clinical approach = primarily relieve overt suffering
research focus on understanding risks
few measures of flourishing used
long-term follow-ups = difficult + expensive
implicit beliefs among

64
Q

8 variables linked to good outcomes after ‘trouble’

A
  • cultural community + family resources
  • treatment variables
    social interactions and relationships
  • personal goals
  • habits / self-regulation
  • emotional cognitive resources
  • temperamental and genetic factors
  • premorbid functioning
65
Q

roadmap for progress

A
  • measure good outcomes thoroughly
    measure good function as potential protective factor
  • don’t focus on risk factors alone
  • no implicit attitude that full recovery doesn’t happen

PYSCH 2B (17 decks)

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