Lecture - Systemic thinking

Question 1

What are the teo ways of thinking about psychiatric presentations?

Answer 1

Systemically - thinking about the systems around the individuals e.g. individual, family sytsem, work/school and peer, ‘local’ community (socia;/cultural/religious), national system, global system

Systematically - 4Ps - predisposing, precipitating, perpetuation and protective factors

Question 2

In systemic thinking, give some contributing factor examples in each system.

Answer 2

This is useful and each child is different and no two children will respons in the same way.

Question 3

What family factors can affect child mental health?

Answer 3

Biological processes:

• Genetic factors - influence all psychiatric disorders, especially Autism, ADHD, schizophrenia; genetic influences on personality/resilience
• Exposures - Alcohol/drug effects on the foetus; safe-keeping of tablets and sharps

Psychological processes

• Models for behaviours and attitudes - social boundaries and law (conduct disorder), education (truancy, school refusal), food (eating disorders), alcohol and drugs
• Young child’s attachment to care-giver - poor early attachment may influence child self-esteem, which may underlie various psychiatric disorders e.g. conduct disorder, depression .
• Experience - of poor parenting, family dysfunction/discord, abuse, parental illness/loss
• Parental mental illness - important to think about but not always a problem

Question 4

How can you describe the expressed emotion (EE) in a family?

Answer 4

• Emotional over-involvement
• Criticism/hostility
• Lack of warmth

High criticism/hostility is linked to:

• child depressive disorder
• conduct disorder
• Schizophremia

Low warmth linked to anorexia nervosa

Question 5

What are the effects of divorce on parents and children?

Answer 5

Parents:

• anxiety disorder
• physical illness
• suicidality

Children

• oppositional behaviour
• anxiety / withdrawal
• play / peer difficulties
• divorce as adults

However, most adjust well.

Question 6

Inerwoven and interconnected

Answer 6

Question 7