Psychology of Health and Wellbeing Flashcards

Question

What study was done on the impact of discrimination and marginalisation on psychological disorders?

Answer 1

Review of 12 studies 2007-2013 , primarily cross-sectional - 55,000+ PPT Discrimination associated with many diagnosed disorders (depression, anxiety, PTSD, eating disorders) Analyses controlled poverty, gender, ethnicity etc. Multiple discrimination Systematic review - 40 studies ‘Resilience’ versus ‘cumulative risk’ Depression, anxiety most common outcome but others studied Strong evidence for cumulative risk and weak evidence for resilience Methodological flaws outlined, but even in stronger studies, racism and heterosexism particularly associated particularly with outcomes

Answer 2

Large scale factors, have important psychological health consequences Poverty, unemployment, inequality Racism, Sexism, Heterosexism Psychologists working with individuals doesn’t address this Need policy, influence, advocacy, campaigning work

Answer 3

Psychological processes: Personal historical factors Cognitive factors Behavioural factors

Answer 4

44 articles published between 2001 and 2011 145,507 PPT Clear associations between early life adversity and all psychological disorders, in development, persistence and severity

Answer 5

Unprocessed memory intrusions (cognitive processes) Formation of negative expectancies and self-beliefs (cognitive processes) Disruption of developmental pathways Disruption of social bonds

Answer 6

Information processing distortions in many cognitive domains all along the ‘information processing chain’ Selective attention --> Memory --> Interpretation --> Cognitive products --> Inhibition Selective attention to threat stimuli in anxiety Selective memory of negative self-related information in depression Overly general memory in depression Absence of selective memory in anxiety disorders Selective interpretations/judgments Intrusive repetitive thinking: worry, rumination Difficulties with inhibitory control

Answer 7

(look at notes for diagram) Internal and/or external triggers --> Perceived threat --> Anxiety Anxiety leads to physiological, cognitive symptoms --> Catastrophic misinterpretation --> Safety behaviours

Answer 8

Cross-sectional studies Studies of recovered patients Longitudinal studies Third variables (e.g. stress reactivity, poverty, abuse)

Answer 9

Classical: Avoidance, escape create habituation; prevents extinction ‘Safety’ behaviours: Mixed evidence Recent rethinking of avoidance: ‘It depends’

Answer 10

Attachment Family dynamics/parenting Peer groups ‘Authority’/leadership figures (e.g. teachers, bosses) Social support/ connectedness Sources of alienation (e.g. Discrimination, bullying)

Answer 11

Ainsworth - Strange Situation - Secure attachment - Insecure attachment Avoidant Ambivalent Disorganised

Answer 12

Secure attachment - Infant is comforted by the presence of their caregiver Insecure attachment - Act very similar with stranger and care giver Strong evidence the insecure attachment is a general risk factors for poor psychological health Some specific relations (depression, anxiety, personality disorders) Personality disorders Anxious attachment → emotional dysregulation Avoidant attachment → Avoidant, inhibited personality Insecure attachment unlikely to be a sufficient cause Requires interplay with other factors

Answer 13

Controversial older literature about family dynamics → High expressed emotion (towards individual) and ‘double bind’ (two conflicting messages, with one neglecting the other) as risk factors for later psychosis But ‘refrigerator’ mother also blamed - Autism caused by lack of mothers warmth More recently family risk conceptualised as ‘Negative Family Emotional Climate’

Answer 14

Different factors accumulate to create a negative family emotional climate (cumulative risk factors approach) E.g. Little warmth or positivity - much criticism + high negative emotional expression + poorly managed parental emotion + psychological controlling behaviours

Answer 15

Well-established links with depression, anxiety Direct links but also indirect via suppressed emotion Factors of instability, adverse life events, family structure & SES, parenting practices, parental verbal conflict, mood problems + disturbed, anti-social, parental behaviour

Answer 16

Overt bullying clearly linked to later psychological health problems, also frequent teasing Teasing and bullying = More likely to children of lower SES Friends offer supp

Answer 17

Buffering hypothesis: Process of: Stressor --> Appraisal --> Response --> Expression in symptoms or behaviour social support may prevent negative appraisal and may facilitate reappraisal, maladaptive response inhibition and/or inspire adaptive responses Offsetting Mechanism: Social support contributes to positive psychological health and can help offset perceived stigma of psychological health diagnosis which can impact positive psychological health

Answer 18

Early life stress - Experiencing sexual abuse, physical abuse, emotional abuse, physical neglect and emotional neglect Carr et al. (2013) - ELS triggers, aggravates, maintains, and increases the recurrence of psychiatric disorders The symptoms of those who experienced ELS can be subdivided into internalizing symptoms, such as anxiety, depression, inhibition, somatic complaints, physiological arousal, fear, avoidance, and re-experiencing, and externalizing symptoms, such as aggression, delinquency, prostitution, exaggerated increased levels of activity, and problems related to sexual behavior

Answer 19

Vargas et al. (2020) Multiply discriminated groups exhibit higher risk for some mental health problems, particularly depression symptoms. However, methodological problems abound in this literature (e.g., correspondence between study sample and types of discrimination assessed), which limits our ability to draw clear conclusions about multiple discrimination

Answer 20

Prior to WW2: ‘Curing psychological illness’ ‘Making everyone’s life more productive and fulfilling’ Identifying and nurturing ‘Giftedness’ in all its forms After WW2: Changed to focus on healing and repairing damage within a disease model of human functioning (positive psychology - also building up positive qualities) Founding of the NHS Founding of the US National Institute for Mental Health

Answer 21

Theoretically-grounded and empirically validated instructions, activities, and recommendations designed to enhance well-being Assigning: Expressing gratitude expression, listing things grateful for Doing acts of kindness Thinking positively about the future Savouring ‘the moment’ Smiling Mindfulness exercises Meditations (e.g. Loving kindness meditation)

Answer 22

Bolier et al. (2013) 39 studies - evaluation 6139 PPT Mostly healthy populations but some aimed at depression or anxiety problems Small to moderate effects for wellbeing and depression (large range d = 0 - 2.4) Small effects at 3- to 6-month follow up Larger effects for individual delivery, face to face, healthcare settings, longer intervention duration Smaller effects in better-quality interventions

Answer 23

Seligman - Flourishing is the result of paying careful attention to building and maintaining the five aspects of the PERMA model. The PERMA model is a model Seligman developed to explain what contributes to a sense of flourishing. The five factors in this model are: Positive emotions, engagement, relationships, meaning and accomplishments

Answer 24

Longitudinal, cross-sectional, experimental research all indicate that each area (family, work, education, religious community) contributes satisfaction, wellbeing, quality of life, good health, life meaning

Answer 25

Very broad construct Measurement problems Contradictions (e.g. meaning and purpose within adversity?) Lack of critical thinking Implicit value judgments

Answer 26

Positive psychology critiques oversimplified Subjective - ‘valued’ experiences and emotions Individual - ‘perseverance, optimism, courage’ Social - Civility, altruism, pro-sociality Recognise that life with no ‘bad times’ is superficial Recognise that out of ‘bad’ can come ‘good’ & vice versa Five conceptual aspects ‘balance’ positive psychology

Answer 27

Avoid extremes Develop complementary among ‘areas’ Temper construct definitions Require contextual sensitivity Acknowledge both: conscious, unconscious phenomena

Answer 28

Based on Paul Gilbert’s work With highly shame-prone and self-critical people Draws on evolutionary theory about ‘social mentalities’ Actively trains, cultivates soothing, kindly stance towards self Draws on Buddhist conceptualization of compassion as: Sensitivity to suffering + Motivation, courage to address relieving it Threat system <-> Soothing System <-> Drive System

Answer 29

Compassion-based intervention effective in increasing self-compassion, reducing distress Compassion: d = .52, 95% CIs [.32-.71], p < .001. (n = 1172) Depression: d = .46, 95% CIs [.25-.66], p < .001. (n = 665) Anxiety: d = .40, 95% CIs [.23-.57], p < .001. (n =1063)

Answer 30

Kashdan & Rottenberg (2010 ) Psychological flexibility spans a wide range of human abilities to … Recognise and adapt to various situational demands Shift mindsets or behavioural repertoires when these strategies compromise personal or social functioning Maintain balance among important life domain Be aware, open and committed to behaviours that are congruent with deeply held values underpins clinical model of acceptance

Answer 31

ACT is updated form of CBT Emphasises accepting unpleasant, painful thoughts, feelings to let them go Articulates personal values Garners commitment to actions Teaches ‘Open, aware, engaged’ responses Underpinned by psychological flexibility

Answer 32

Hayes et al. (2006) - Substantial evidence that psychological flexibility with less distress and psychopathology (r = .42) Lab studies saw psychological flexibility procedures produced large effects (Levin, 2012) Gloster (2020) - Found meta analytic effects favour ACT .57 for ACT and .16 for CBT

Answer 33

CMT focuses on three systems of threat, soothing and drive - more restrictive than ACT which emphasises a shift in mindset if there is a compromise in social functioning

Answer 34

PTM brings together macro factors Brought into useable explanatory framework Proposed as alternative to diagnostic classification ‘What has happened to you?’ – (What role did Power play? Whose Power?) ‘How did it affect you?’ – (What kinds of Threats did this pose?) What sense did you make of it?’ – (What Meaning(s) did/do these situations, experiences have for you?) What did/do you have to do to survive?’ – (What kinds of Threat Response are you using?) ‘What are your strengths?’ – (What access to Power resources do you have? What Powers do you have yourself?) ‘What is your story?’ ⎯ (How does all this fit together?)

Answer 35

Refugee - experienced war, genocide, beaten and physically neglect Moved to UK - not working due to poor psychological health + strained relationship with wife and son Marko presented with Flat mood, lacked pleasure, frequently tearful, poor motivation Easily started, frequent panic attacks, constantly tense, nightmares Avoided anything associated with previous experiences Numbed/blunted - no sense of future Some suicidal thought but no plans or actions Application to the power threat meaning network How do we understand ‘where Marko is’ from the perspective of Power, Threat & Meaning? ‘What has happened to you?’ – (What role did Power play? Whose Power?) ‘How did it affect you?’ – (What kinds of Threats did/does this pose?) ‘What sense did/do you make of it?’ – (What Meaning(s) did/do these situations, experiences have for you?) ‘What did you have to do to survive?’ – (What kinds of Threat Response are you using?)

Answer 36

State-sanctioned violence against his ethnic group Forced removal from his home by militia Daily abuse/dominance/imprisonment/threat After liberation: forced refugee status Becoming an ethnic minority in to-him-foreign UK Neighbourhood harassment Unemployment, social stigma and exclusion Impact: Virtually instantly: legally/’legitimately’ robbed of security, identity sources: work, community, wife, family, culture, fun, hobbies Extreme threat response: hypervigilant, startled, nightmares, constantly highly aroused/anxious/angry/frustrated Ongoing low-level social threat: not belonging, feeling unwelcome, afraid

Answer 37

His symptoms are responses to repeated trauma, systematic powerlessness, destruction of his way of life Marginalisation UK made his life more difficult Foreshortened future sense and numbing are rational (not ‘disordered’) ways of trying to dampen intense fear Not receive PTM treatment Used cog therapy/ exposure base to build understanding of trauma

Answer 38

Traumatic event(s) --> Extreme threat appraisals --> fear activated --> Avoids cues, stimuli --> Memories, events narratives are unprocessed --> intrusions/flashbacks (FEEDS BACK INTO EXTREME THREAT APPRAISALS)

Answer 39

Marko early sessions Found it hard to talk More fearful & have more intrusions in the day after Trusted consultant, felt could continue As felt more comfortable , gradually revealed more of his story Began by expressing anger at suffered injustices Marko mid sessions Came to understanding that numbing was his way of coping with his experiences Hopelessness, feeling disconnected, not going outside his community Costing connections with wife & child Marko later sessions Began to find courage to risk, experiment again Talked to his wife more Encouraged others in his community to talk Recognised UK must become his home Power threat meaning Key was getting him a safe place to express rage at injustice done to him Acknowledging feelings of marginalisation

Answer 40

The work done with Marko was consistent with PTM framework Marko’s situation was ‘ripe’ for PTM – it outlined mechanisms ‘at work’ in his situation Narrative-and meaning-making helped Consultant was guided by PTM-type model of trauma that suggested mechanisms and ways to address them – acknowledge exposure, reduce avoidance of further threat, come to more adaptive narrative of meaning Underlying mechanisms are linked to DSMV-defined disorder PTSD, but it’s the mechanisms that were important, not so much specific ‘disorder symptoms’

Answer 41

Conceptualising mechanisms as beyond intrapsychic (social justice, agency, marginalisation) aids understanding, but intervention is optimally ultimately individual

Answer 42

There are always both present ‘situation’ and our reactions to it Situation is other people involved, social/physical circumstances To change situation Leave it, do something to alter course Can’t always do these things In particular we can’t make other people behave the way we want them to We can always change our own reactions

Answer 43

Composed of six overlapping and interdependent processes Called the ‘Hexaflex’ (Hexagonally shaped visual aid) Each has flexibility and flexibility ‘sides’

Answer 44

Inflexible: - Experimental avoidance - Dominance of past and future - Lack of clarity and/or contact with values - Lack of effective action - Attachment to a self-story - Cognitive function

Answer 45

Open: Willingness/acceptance + Cognitive defusion (looking at thoughts rather than from them) Engaged: Contact with the present moment + Flexible perspectives about 'stories' Aware: Clarity about, contact with personal values + Committed actions towards values

Answer 46

Awareness Mindfulness meditation, raisin exercise Daily diary tracking psychological flexibility Paying attention whilst doing three tasks Openness Acknowledging and validating experiences ‘It is normal to be upset about this’ Noticing tendency to avoid, encouragement to lean in Singing difficult thoughts/saying them in a funny voice ‘Leaves on a stream’ exercise - Meditation on principle of cognitive defusion to cope with uncomfortable thoughts and feelings Engagement Two sides of a coin metaphor ‘Sweet-spot’ exercise - Makr room for all the feelings that arise ‘Qualities of our heroes and heroines’ exercise Generating actions Making public commitments SMART goal-setting

Answer 47

Ideas here likely exactly what’s needed Getting people to accept , commit is tricky People need to want to change, be willing to work at it If they do and can, they will Data on all exercise here very mixed For some, they work great Placebo effect is real Don’t worry if they don’t find your own way to accept, commit

Answer 48

It implies that even when a good outcome or conclusion seems certain, things can still go wrong - E.g with ACT, practicing positively can't always occur

Answer 49

Difficult to measure direct outcome of the methods as they rely on self-guided mental effort to complete - ensure consistency between PPT?

Answer 50

Don’t really know Clinical approach is primarily to relieve overt suffering Research focus is on understanding risks of ‘disorder’ Few measures of ‘flourishing’ available Need long-term follow ups - difficult, expensive Implicit beliefs among clinicians that few do go on to do well

Answer 51

Rottenberg et al. (2018): Archive data on US 'population-representative' sample Given diagnosed depression - what proportion later had no symptoms + on multifaceted wellbeing profiles scored in highest 25% of people never diagnosed. Profile = Rate on: life satisfaction, negative affect, positive affect, autonomy, environmental mastery, personal growth, positive relations with others, purpose in life and self-acceptance Results 10% of those diagnosed with depression were, 10 years later, symptom free and functioning 25% better than those never diagnosed - not great recovery prospects but somewhat improved Overall, diagnosed group scored half as well as non-diagnosed group Anxiety disorder not nearly as good

Answer 52

Most people go through psychological troubles without diagnosis Even most of these recover and thrive Even the most serious disorders seem to moderate with age

Answer 53

Cultural. community and family resources Treatment variables Social interactions and relationships Personal goals and projects Habits and self-regulation Emotional and cognitive resources Temperamental and genetic factors Premorbid functioning

Answer 54

Measure good outcomes more thoroughly, accurately, often Measure good function as potential protective factor too Don’t focus simply on risk factors Root out implicit attitude that full recovery doesn’t happen Research how to help people live well

Psychology of Health and Wellbeing Flashcards

(78 cards)