IDIS 199 > Module 5 > Flashcards

Module 5 Flashcards

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1
Q

Resiliency

A

ability to adjust or recover from a stressor, threat or adversity

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2
Q

Managing Distress

A

being able to manage distress refers to learning how to cope with negative or difficult emotional states.

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3
Q

Learning to manage distress is a form of

A

Self-regulation

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4
Q

tipping point

A

when stress ad challenges exceed optimal performance and become too great to manage

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5
Q

the tipping point is the point at which someone begins

A

showing signs/symptoms of the strain/burden of perceived stress

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6
Q

is the tipping point the same for everyone

A

no

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7
Q

how can you conceptualize the tipping point

A

through stress diathesis model

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8
Q

stress part of stress diathesis

A

-stress tirggers several interconnected biological systems
-the process by which the body adapts to changes (like stress) is called allostasis

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9
Q

what is essential for maintaining balance in the face of challenges

A

allostasis

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10
Q

Diathesis part of stress diathesis

A

-concept of vulnerability
-a persons predisposition or vulnerability to a medical condition
-can be through genetic interetance, psychosocial vulnerability created by exposure to a stressor in early life, or vulnerability created by interaction between genetics and environmental factors

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11
Q

the stress diathesis model explains

A

a disorder or behaviour through an interaction between genetic predisposition and stressful exposure (acute, chronic or cumulative)

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12
Q

why does the tipping point vary a lot between individuals

A

because there is so much variability across the presence of risk factors

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13
Q

McEwan and Gianaros study

A

results indicate that stress can trigger allostasis-induced brain plasticity, suggesting that stressful experiences can affect brain structure and function

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14
Q

brain plasticity

A

the ability of the NS to change its activity in response to intrinsic or extrinsic stimuli by reorganizing its structure, functions or connections

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15
Q

McEwan and Gianaros study the brain and regulation findings

A

-brain in central in stress diathesis model
-brain determines what is threatening and what is positive experinces
-the brain is responsible for regulating an individuals physical, emotional, behavioural and cognitive responses to stressors

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16
Q

McEwan and Gianaros study stress findings

A

-stress must be balanced
-stress is manageable can lead to positive growth and adaptations (steeling effect) promoting resilience and good health

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17
Q

steeling effect

A

evidence of more resistance to later stress having successfully coped with a stress/challenge

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18
Q

McEwan and Gianaros study stress and health findings

A

-too much stress (chronic or cumulative) or acute overwhelming stress, takes a toll on the brain and body
-associated with poor mental health and physical health outcomes

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19
Q

McEwan and Gianaros study brain structure findings

A

-whens tressed the brain changes structure in an adaptive or maladaptive way
-the loss of resilience is a key feature of disorders related to stress

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20
Q

according to stress diathesis model: stress influences

A

how you think and feel emotionally and physically

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21
Q

stress diathesis adaptation model: percieved stress

A

-the brain processes information from internal and external environment
-given genetics and life experience your brain processes the same stress differently
-these factors determine level of perceived stress

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22
Q

stress diathesis adaptation model: physiological responses

A

-responses to stress include metabolism, heart rate, anxiety, emotions, how you speak to yourself and behave
-responses result via the HPA axis, the autonomic NS, the metabolic system, the gut, and the immune system

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23
Q

stress diathesis adaptation model: allostatic load

A

-the wear and tear on the body and brain resulting from chronic dysregulation or overactivity
-interventions to alleviate the allostatic load include healthy diety, sleep, exercise, social support, connectedness
-participating in ways to relieve allostatic load may also help develop resilience in the event of adversity

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24
Q

Genetics x Environment (GxE interactions influence susceptibility to all experiences by:

A

reducing risks and flourish

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25
GxE reducing risks:
your gentics interacts with life experiences good and bad to determine resiliency and sensitivity to stress. Developing healthy ways to cope with stress and adversity can reduce the risk of feeling overwhelmed and developing symptoms
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GxE flourishing
young people are at a particularly important time in development, increasing the likelihood of positive effects on well-being
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two most common mental health disorders in canada
anxiety and depressive
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Prevalence of disorders in canada
3 million live with anxiety/mood dosorder and 1/4 have not gotten treatment in last year
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is anxiety or depression more prevalent in canada
anxiety by 2%
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are depression and anxiety more prevalent in males or females
females
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types of S&S with anxiety and depression
emotional, physical, behavioural and cognitive
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S&S persist and are associated with distress/impairment means
disorder
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Emotional S&S of anxiety
-feeling on edge -feeling irritable -not fully enjoying things
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Phsysical S&S of anxiety
-restless -tight chest -muscle tension -shortness of breath -GI upset -headaches -sweaty palms -butterflies -change in appetite -flushing -fatigue -rapid pressured speech
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Behavioural S&S of anxiety
-avoidance -short temper and angry -difficulty sleeping -difficulty concentrating, distracted and forgetful
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Cognitive S&S of anxiety
-apprehension -over-worry -distracted
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symptoms of anxiety can overlap with
ADHD, depression, Cardiovascular problems
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Emotional S&S of depression
-feeling sad -non-reactive mood -feeling despair -loss of enjoyment of normally enjoyable activities
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physical S&S of depression
-changes in sleep (less or more) -changes in appetite (less or more) -slowed movements, agitated or restless -pain,headahces
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Behavioural S&S of depression
-withdrawing from friends/family -staying in more -missing class/work
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Cognitive S&S of depression
-feelings of guilt -suicidal -hopelessness -difficulty concentrating -dwelling on negatives -thinking over past bad memories and experiences -negative thinking
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Four indicators that suggest a concern/problem
1. disproportionate reaction 2. time 3. impairment 4. out of character
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disproportionate reaction
severity or intensity of symptoms and level of distress are disproportional to situation
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time
symptoms persist for an extended period of time past the stressor
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Impairment
symptoms are associated with and interfere with day-to-day life
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out of character
others notice that the person does not seem themselves or is off
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aspects of a mental disorder diagnosis
-symptoms may indicate a disorder, but a diagnosis is not a simple checklist -require assessment by mental health professional who takes into account the whole person
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what other factors are taken into account during an assessment
bullying, academic problems, relationship problems, substance use, family history, recreation, and exercise
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information required to assess mental health status
-Developmental history -family history -symptoms -treatment -other factors -relational and social factors
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developmental history
-learning, communication/neuromotor problems, childhood adversity
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family history
a predisposition, or genetic and family vulnerability
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Symptoms
clinical course of distressing and impairing symptoms, in terms of onset and nature (chronic or episodic) and relationship to context
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treatment
the response or paradoxical worsening to any treatment tried to date and other physical/medical problems that may be contributing
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other factors
lifestyle (exercise, recreation), misuse of alcohol.drugs, current stressors, etc
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relational and social factors
nature of relatonships, connectedness and environment
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Circle of mental health care: student first contact
normally reach out for help on campus at student wellness services or through family practice, less common to be referred to specalized psychological therapy for psychiatric consultation
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Primary care provider
Family doctor: should be thought of as central to coordinating your health and mental health care - first line for assessment of a mental health concern and provide continuity and coordinate your care -ideally should be kept up to date with any health or mental support you receive
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Counselling
provided through student wellness services is often short term and problem focused, addressing healthy coping during periods of stress, strengthening problem solving skills and managing responses to an identified stressor
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Psychiatry
well-suited for assessing and treating moderate to severe mental health conditions or disorders that require combined psyiological and phamalogical treatment approach
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Psychological Therapy
well-suited to help with support with emotional, social, and mental health problems of moderate severity
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Peer support
being able to take to other students. Ex. buddy system or confidential service where you can talk to other students -peer mentors can help by empathising, sharing information, and sharing own experiences -sometimes feel easier and less daunting to speek to a peer
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Self-help
using available resources such as books ,websites, or apps to work through a problem - effective for many diff types of problems and accessible/convenient to use at your own pace
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Stepped care approach aims to
match individual patients to the level of service indicated based on intensity of need
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bottom of stepped care pyramid
entry level services: lowest intensity required to meet individual needs (nothing to do with effectiveness)
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each step in the pyramid of stepepd care represents
a progressive increase in the level of intensity of treatment and the expertise brought to bear into that treatment
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as you step up youre looking at
smaller subgroups of patients
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examples of bottom of pyramid
campus-based student mental health care or self-guided well-being resources
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top of the pyramid
requires most intense care: hospital-based services (emerg)
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2 keys to safe and effective stepped care
1. the level of care an individual recieves matches the indicated clinical need 2. the steps represent evidence-based effective treatment
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the model of stepped care assumes that
1. the minimally required intervention has itself benefits and gains (every step is evidence-based and effective appropriately matching need of patient) 2. this is a way to rationalize and economize healthcare resources that are usually limited, so individuals have the indicaed level of treamtnet and not more than they need 3. the care provided is acceptable to patients so each level is convienent, accessible and has flexibility
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people who provide mental health support
-OT -Counsellor -Psychotherapists -Clinical Psychologist -psychiatrist
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OT role in MH support
-specialize in assessment and intervention focused on helping people resume or maintain participation of activities -well-suited to help with learning approaches, and improving performance to achieve a balanced study/work life
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Counsellor role in MH support
-variable training -short-term and problem focused -can support healthy coping, emotion and behaviour regulation, healthy lifestyle choices and good balance -usually free of charge and often limited number of sessions
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Psychotherapists role in MH support
-licensed healthcare professionals with training in group and individual psychologial talking therapies -different "schools"/models including CBT, IPT, and more -well-suited to support individuals with emotional, social, and mental heath problems from mild to moderate severity
75
Clinical Psychologist role in supporting MH problems
-registered healthcare professionals (regulated) -usually requries PhD -extensive training in providing manualized effective group and individual therapeutic approachesto help with MH problems --well-suited to provide support and treatment from mild to moderate problems and part of multidisciplinary team supporting moderate to severe
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Psychiatrist role in supporting MH problems
-medical doctors with extensive training in diagnosis and treatment of disorders -integrates pharmalogical treamtent -rooted in medical approach, takes into account developmental and family history, psychosocial context, early adversity onset and clinical course -access occurs through referral only
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Ideal mental health system model
start with a welcoming clinical visit to determine each students support need, followed by referrals to appropriate level of service and support (stepped care model) **ideally also seamless flow between levels of service
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is stepped care in ontario
no
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Campus resources at queens
-queens student health and wellness -queens student accessibility services (Part of QSWS) -Psychology clinic at queens
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queens student health and wellness
supports personal, academic, and social health development of students at queens by providing a range of programs and services, including physical and mental barriers
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queens student accessibility services
supports personal and mental health of students and their academic success through a range of resources and services
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Psychology clinic at queens
psychological assessments, treatment, and consultation for students and members of community, this clinic operates on a fee for service model but sliding scale offered based on family income
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types of community based services
- hospital-based -publically funded -private and fee-for-service
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Hospital-based services
emergency/urgent care & subspecialty programs which have defined criteria for admission
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Publicly funded community based services
high demand plus limited funding means these have long wait lists and prioritize most ill, do not generally line up with university demographic
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Private/fee-for-service
because OHIP do not cover psychotherapy, many people rely on fee for service -some insurance companies will cover this
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3 types of barriers to mental health care
Stigma related, attitudinal, practical
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Stigma-related
-fear of being evaluated negatively --CMHA working to combat stigma by education
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Attitudinal barriers
-people invalidate their own or others MH problems -often misunderstanding
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Practical Barriers
-long wait times -financial barriers -challenges navigating the system (know what services you need and where to get them)
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four categories of intervention
No symptoms, mild symptoms, mild to moderate symptoms and moderate to severe symptoms
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intervention of no symptoms
prevention and health promotion
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intervention for mild symptoms
self-help targeted for S&S
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intervention for mild to moderate symptoms
social and/or psychological approaches
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moderate to severe symptoms
pharmacological and psychological approaches
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U flourish study on digital intervention
testing digital interventions to reduce anxiety, stress and low mood and tackle worry, self-criticism and low confidence, free of charge
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social approaches may benefit
mild mental health symotms
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socail approaches include
supports thatc can improve your social support and well-being; social skills workshops, interest groups/clubs, health promotion, and support groups
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psychological appraoches may be helpful when
MH symptoms persist, moderate situations
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Psychological approaches can be delivered
individuall or in a. group and may include a variety of therapy modalities
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examples of psychological therapy modalities
-CBT -CPT -IPT -Supportive counselling -Behavioural activation -Mindfulness-based stress reduction
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Mindfulness based stress reduction
useful for being mentally presently focused and relaxed
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Behavioural activation
evidence-based treatment based on increasing your activity level, especially in pleasurable activities to combat low mood
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Supportive counselling
having a supportive person to explore current issues and difficulties, and look for different ways of approaching them
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Interpersonal Psychotherapy
relieving symptoms by improving interpersonal functioning, focuses on understanding and strengthening your relationship with yourself and others
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Cognitive Behavioural Therapy
-Effective in treating mild-moderate sleep problems, anxiety, and depression -evidence-based therapy that involves addressing an =d changing maladaptive thinking patterns as well as modifying behaviour
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CBT can be used to treat
anxiety, depression, EDs, and trauma
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CBT is especailly useful when
combined with other psychosocial and educational approaches including medication
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2 mindfulness exercises
1. focus on an object 2. focus on breathing
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considerations involved with medical and pharmacological approaches
Alternative medical explanation, medication, physical and mental health interaction
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Alternative medical explanation
important to consider whether there might be a medical explanation for symptoms ex. thyroid problems affect mood -genetic predisposition (family history)
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Medication
family doctors work in collab with psychiatrists to identify when medication is required to assess the tolerability and treatment response
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Physical and mental health interaction
often physical illness are associated with mental health problems and vice versa
IDIS 199
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