Mental Health

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Mental Health
2013-09-04 02:11:49
Mental Health

Chapter 18
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  1. Mental Health
    A state of emotional and social wellbeing where an individual can interact with others and the environment, cope with normal stresses and achieve optimal development and wellbeing
  2. Mental Illness/disorder
    A psychological dysfunction that involves impaired ability to cope with everyday life

    Typical characteristics include distress, unusual thoughts, feelings and inappropriate behaviour
  3. Disease
    Identifiable physiological change associated with an abnormal body condition
  4. Normality
    pattern of thoughts, feelings and behavior that conforms to a usual, typical or expected standard
  5. Abnormality
    pattern of thoughts, feelings and behaviour that is dysfunctional, deviant or distressing
    • So Fresh Hits of Summer May Sizzle
    • Socio-cultural: thoughts, feelings and behaviour that are acceptable in a particular society or culture but can be considered as unacceptable in another.

    Functional: normal behaviour is if the individual can undertake everyday tasks and cope (function) effectively with life in society.

    Historical: thoughts, feelings and behaviour that are considered as normal/abnormal in a society within a particular era, or period of time.

    Situational: thoughts, feelings and behaviour that are viewed as normal in one setting/context and abnormal in another.

    Medical: Normality is defined on a physiological basis

    Statistical: normality follows a normal distribution; thoughts, feelings and behaviour are viewed as normal if fallen into the ‘statistical average’ and considered abnormal if fallen into ‘statistical extremity’ displayed on a bell curve.
  7. Categorical Approach
    Organises mental disorders into categories and sub-categories, each with specific symptoms and characteristics. It uses a ‘yes/no’ approach in that you either have a mental disorder or you don’t. Classification needs to be valid and reliable.
  8. DSM-V
    Categorical system that classifies disorders based on symptoms described

    It does not suggest causes or treatment of specific disorders but rather simply names the disorders and describes them in specific terms, more specifically:

    • o    How the disorder will progress (typical course of the disorder)
    • o    The age at which a person is most likely to develop the disorder
    • o    The degree of impairment
    • o    How common it occurs
    • o    Whether the disorder is likely to affect others in the family
    • o    The relationship of the disorder to gender, age and culture

    Around 400 disorders; 17 categories
  9. Axis I - Clinical disorders
    • Any major psychological disorder. It includes symptoms that cause distress or significantly impair social or occupational functioning. These disorders are typically present of part of the patient’s life.
    • (e.g. anxiety disorders, mood disorders, schizophrenia).
  10. Axis II - Personality disorders & mental retardation
    • Personality disorders/chronic and enduring problems that generaly persist throughout life and impair interpersonal or occupational functioning
    • (e.g. multiple personality disorder / obsessive-compulsive disorder).
  11. Axis III - General medical conditions
    • Physical disorders that may be relevant to understanding or treating a psychological disorder from Axis I and II
    • (e.g. diabetes, cancer, hypertension, heart disease).
  12. Axis IV - Psychosocial & environmental problems
    • Problems (such as interpersonal stressors and negative life events) that may affect the diagnosis, treatment and prognosis of psychological disorders
    • (e.g. isolation, family break-up, unemployment).
  13. Axis V - Global assessment of functioning (GAF)
    The individual’s overall level of functioning in social, occupational and leisure activities in which the patient is given a score out of 100 (a high score means good functioning in all areas and minimal symptoms).
  14. ICD-10
    • 21 chapters for the whole medical practice, with ch.5 on mental disorders
    • More general categories
    • 300 mental and behavioural disorders
    • Primarily used in Europe
  15. Categorical approach - Strengths
    • Based on scientific research which is constantly being updated
    • Diagnoses enables a treatment plan

    Is user friendly

    Enable easy communication among mental health professionals
  16. Categorical approach - Limitations
    • Categories and sub-categories can overlap – symptoms aren’t specific enough
    • Stigmatisation

    Low inter-rater reliability with some disorders
  17. Dimensional Approach
    A system of diagnosis in which conditions are assessed by the extent to which patients show particular symptoms. Disorders are ranked on a continuum based on testing following patients completing inventories (e.g. EPQ-R)
  18. Dimension
    • A cluster of related psychological/behavioural
    • characteristics that occur together and can be measured

    The numerical values are compared with the statistically ‘normal’ expected values for each characteristic.
  19. Dimensional Approach - Strengths
    • Generates detailed patient profiles for best possible treatment
    • Reduces presence of stigma
    • Higher validity and reliability when grading symptoms

    Not limited to one category – all info may be used
  20. Dimensional Approach - Limitations
    Time consuming to rate

    Can be disagreement regarding dimensions

    Can’t be applied to most disorders in DSM and ICD – mostly personality disorders
    A holistic approach to describing and explaining how biological, psychological and social factors combine and interact to influence physical and mental health