Indigenous Perspectives on Wellness

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Questions and Answers

How do typical antipsychotics primarily manage positive symptoms of schizophrenia?

They block D2 receptors, which reduces dopamine activity linked to positive symptoms.

What is the dopamine imbalance hypothesis in relation to schizophrenia symptoms?

It suggests that excess dopamine in the mesolimbic pathway causes positive symptoms, while reduced dopamine in the mesocortical pathway causes negative symptoms.

What role do atypical antipsychotics play regarding serotonin in treating schizophrenia?

Atypical antipsychotics block 5-HT2A receptors, influencing serotonin's modulation of dopamine pathways.

What complications are associated with first-generation antipsychotics compared to second-generation antipsychotics?

First-generation antipsychotics have higher risks of extrapyramidal symptoms, while second-generation have a higher risk of metabolic side effects. Signup and view all the answers

Describe how neuroanatomical abnormalities are observed in individuals with schizophrenia.

Individuals often show enlarged ventricles and reduced size in prefrontal and temporal lobe structures. Signup and view all the answers

What psychosocial factors are correlated with an increased risk of developing schizophrenia?

Low socioeconomic status and social exclusion are linked to higher prevalence and risk. Signup and view all the answers

How do cognitive behavioral therapies address symptoms of schizophrenia?

They focus on engagement, normalization, and developing alternative explanations for symptoms. Signup and view all the answers

What are third-generation antipsychotics, and how do they function?

Third-generation antipsychotics, like aripiprazole, act as partial D2 agonists, stabilizing dopamine activity across pathways. Signup and view all the answers

What are the four dimensions of wellness emphasized in Indigenous perspectives?

Physical, emotional, mental, and spiritual wellness. Signup and view all the answers

How does Indigenous knowledge contrast with Western approaches to mental health treatment?

Indigenous knowledge emphasizes balance and interconnectedness, while Western approaches often prioritize individualism and empirical evidence. Signup and view all the answers

What is meant by saying that the earth is viewed as a 'mother figure' in Indigenous perspectives?

It signifies a deep respect for the earth as a nurturing entity that provides life and wisdom. Signup and view all the answers

What is one consequence of colonialism on Indigenous cultural practices?

It led to cultural dissociation, including the separation of children from their traditions through institutions like residential schools. Signup and view all the answers

What role do emotions play in Indigenous healing practices?

Emotions are viewed as valuable sources of wisdom and guidance in the healing process. Signup and view all the answers

In what way does the Diné (Navajo) healing chantway system function?

It involves diagnostic and restorative ceremonies that use ancestral stories, herbs, and rituals over several days. Signup and view all the answers

What is the primary purpose of diagnostic classification in mental health?

To aid clinicians and researchers in managing and understanding complex realities of mental disorders. Signup and view all the answers

What are the key differences between the ICD and DSM in the context of mental disorders?

ICD is a globally recognized system developed by WHO, while DSM is more detailed and preferred for research and clinical practices in North America. Signup and view all the answers

How did Emil Kraepelin contribute to the field of mental illness classification?

He created the first classification system for mental illnesses and introduced the concept of distinct syndromes with specific symptoms. Signup and view all the answers

What major change occurred in the DSM-5 regarding Autism Spectrum Disorder (ASD)?

ASD was redefined to encompass Asperger’s disorder, childhood disintegrative disorder, and pervasive developmental disorder into a single category. Signup and view all the answers

What is a key recommendation for psychotherapists working with Indigenous clients?

Psychotherapists should adopt a client-centered approach, allowing clients to define their healing paths and include family and community. Signup and view all the answers

What is meant by 'intergenerational trauma' in the context of colonialism?

It refers to trauma that is passed down through generations due to historical injustices like colonization. Signup and view all the answers

What are some characteristics of the biopsychosocial framework in understanding Indigenous healing?

It recognizes the integration of mind and body during rituals and the importance of community in enhancing healing. Signup and view all the answers

What does the phrase 'life is seen as a journey of cleansing, growth, and transformation' signify in Indigenous perspectives?

It emphasizes the ongoing process of personal development and healing that is central to the purpose of life. Signup and view all the answers

What are the key concerns regarding the validity and reliability of diagnostic categories in mental health?

Diagnostic categories are constructs rather than objective entities, raising concerns about cultural biases and overdiagnosis. Signup and view all the answers

How do dimensional approaches to diagnosis differ from categorical approaches like the DSM?

Dimensional approaches use scales to capture symptom severity and variation, whereas categorical approaches classify symptoms as either present or absent. Signup and view all the answers

What role does the amygdala play in anxiety disorders?

The amygdala is crucial in the fear response and emotional memory, influencing the experience of anxiety. Signup and view all the answers

What are some common specific phobias, and how do they typically manifest?

Common specific phobias include fear of animals, heights, and blood, leading to avoidance behaviors and significant distress. Signup and view all the answers

What is the lifetime prevalence of panic disorder, and how is it characterized?

Panic disorder has a lifetime prevalence of 2-3% in men and 5-6% in women, characterized by recurrent, unexpected panic attacks. Signup and view all the answers

How does the sociocultural perspective explain the prevalence of Generalized Anxiety Disorder (GAD)?

The sociocultural perspective links GAD to societal stressors like poverty and disasters, with greater prevalence noted in higher-income countries. Signup and view all the answers

What are positive symptoms of schizophrenia, and how do they differ from negative symptoms?

Positive symptoms include hallucinations and delusions, while negative symptoms involve deficits like reduced emotional expression. Signup and view all the answers

What is the significance of the tripartite model in distinguishing anxiety from depression?

The tripartite model differentiates anxiety through physiological hyperarousal and depression through anhedonia. Signup and view all the answers

What treatments are commonly used for panic disorder?

Common treatments include SSRIs, tricyclics, and cognitive-behavioral therapy (CBT) to correct misinterpretations and gradually expose triggers. Signup and view all the answers

What are some criticisms of the DSM and ICD regarding mental health diagnoses?

Critics argue they reflect cultural biases, can lead to overdiagnosis, and may promote unnecessary medication use. Signup and view all the answers

Describe the potential impact of social media on anxiety disorders.

Social media can exacerbate anxiety by promoting constant comparison and reducing real-life interactions, leading to increased anxiety linked to online approval or rejection. Signup and view all the answers

Explain the concept of 'prepared learning' in the context of phobias.

Prepared learning suggests that humans are biologically predisposed to fear certain stimuli, such as snakes, due to evolutionary advantages. Signup and view all the answers

What inherent challenges exist in validating new diagnoses in mental health?

No definitive scientific methods exist for validating new diagnoses, which raises concerns about evidence, clinical utility, and potential harms like overmedicalization. Signup and view all the answers

How do benzodiazepines function in the treatment of anxiety disorders?

Benzodiazepines act as GABA agonists to reduce symptoms of anxiety by enhancing the inhibitory effects of GABA in the brain. Signup and view all the answers

Study Notes

Indigenous Perspectives Slides

Over 50 distinct Indigenous Nations exist
Wellness encompasses four dimensions: physical, emotional, mental, spiritual, and extends to family, community, and land relationships
Indigenous knowledge offers a contrasting approach to Western methods for mental health, emphasizing balance and integration of various effective approaches
Indigenous paradigm views the earth as a mother figure and teacher, valuing the human mind as a tool for harmony and the role of emotions as sources of wisdom and guidance
Indigenous understanding of spirit transcends organized religion, emphasizing connection with spirit for the greater good
Life is seen as a journey of cleansing, growth, and transformation

Indigenous vs Western Paradigms

Indigenous relationship with the earth is one of reverence, viewing it as a mother figure
Indigenous purpose of the human mind is harmony and balance among all beings
Indigenous emotions are seen as valuable sources of wisdom and guidance
Indigenous view of spirit transcends organized religion, focusing on the essence of all life, fostering connections for the greater good
Western relationship with the earth is a resource or commodity
Western purpose of the human mind is innovation and achievement of individual potential
Western emotions are to be controlled and aligned with societal expectations
Western understanding of spirit is often tied to religion, separated from daily life, and viewed as a personal choice
Western definition of knowledge is empirical proof through science or logic

Impact of Colonialism

Indigenous peoples were viewed as primitive (terra nullius)
Colonization separated children from traditions
Colonialism forced a colonizing sense of self
Trauma and dissociation resulted from cultural dissociation, most notably residential schools, creating intergenerational traumas

Healing from Colonial Violence

Acknowledgement and letting go through forgiveness and ceremonial methods, such as washing away grief
Reconnecting with Indigenous values and spirituality in relationships
Reinforcing relationships of love, respect, and confrontation with oppression

Diné (Navajo) Healing

Navajo healing practices involve ceremonies and rituals to restore balance and return the patient to their origins
Includes diagnostics and healing rituals, using ancestral stories, herbs, chanting, integrating group psychotherapy and art therapy

Western Models for Understanding Indigenous Healing

Cognitive and narrative approaches to interpret cultural symbols
Biopsychosocial frameworks promote integration of mind, body, and community during rituals to enhance healing

Community Role

Social bonding during ceremonies enhances healing and immune response

Recommendations for Psychotherapists

Advocacy and cultural awareness regarding colonization's impact on Indigenous peoples
Respecting Indigenous knowledge and practices; respecting diverse priorities and definitions for healing methods
Include family and community in wellness discussions
Strengths-based methods should focus on resilience and existing individual strengths

Classification and Diagnostic Manuals

Classification is a practical tool in managing complex mental realities
Diagnostic classifications aid clinicians and researchers in understanding mental disorders
ICD-11 and DSM-5-TR provide structured frameworks for diagnoses, encompassing all medical and psychological disorders

Major Diagnostic Manuals

ICD-11 is WHO-developed, legally binding globally for coding health information; most frequently used worldwide
DSM-5-TR is often the preferred choice for research and clinical practice, focusing on mental disorders

Classification of Mental Disorders

ICD-11 and DSM, both standards, use specific types for mental disorders, such as mood, neurodevelopmental etc.

Major Changes from DSM-IV-TR to DSM-5

Autism, OCD, and other disorders were reclassified, often regrouped
DSM-5 introduced a more broad categorization scheme emphasizing shared traits between various types of disorders

Criticism of DSM and ICD

Validity and reliability of diagnostic categories are questioned, with some critiques on their objectivity and cultural biases; the diagnoses reflect societal norms instead of universal truths
Overdiagnosis, increased prevalence of other disorders, like autism, ADHD, and PTSD, can result from expanded diagnoses and criteria thresholds
Pharmaceutical influence can also lower thresholds for diagnoses or cause unnecessary medication use

Trends and Future Directions

More dimensional diagnoses that take advantage of biological and psychological markers
Other frameworks emphasize measurable biological underpinnings, possibly bridging the gap between psychiatry and neuroscience.

Discrete vs. Dimensional Classification

DSM uses categorical approaches (yes or no), while dimensional approaches use scales (e.g., 1-10) to capture symptom severity
Dimensional classification aligns better with real-world presentations and complex clinical communication
The debate emphasizes the tension between simplicity for utility and the more nuanced complexity for understanding

Adding New Diagnoses

New diagnostic additions should weigh evidence, clinical utility, and the potential for overmedicalization

Anxiety Disorders Overview

Characterized by cognitive, emotional, physiological, and existential aspects, including thoughts, worries, fear, feelings of agitation, and concerns for life's meaning
Associated with heightened physiological responses
Rooted in cognitive appraisals and physiological vulnerabilities
Highlights the amygdala and pre-frontal cortex (PFC) as key brain areas

Neurobiology of Anxiety

Amygdala: involved in fear responses and emotional processing
PFC / ACC: modulates primitive emotional responses through regulation
Neurochemicals like cortisol, adrenaline, norepinephrine, and GABA regulate the brain's response to anxiety

Anxiety Disorder Prevalence and Comorbidity

Affects women and young adults more often
Significant comorbidity with depression, substance use disorders, and PTSD
Often involves biological and psychological underpinnings, as well as an overlap with depressive responses (e.g., high arousal vs anhedonia)

Phobias Overview

Extreme or irrational fears that lead to avoidance of specific objects or environments
Subcategories include animals, situations, natural environments, blood, etc.

Classic and operant conditioning can explain the development of fears and avoidance through stimulus response theory
Prepared learning suggests a biological predisposition to certain phobic objects, while cognitive distortions exaggerate risks and undervalue performance
Social media amplifies anxiety vulnerabilities through social comparison, decreased real-life interactions, and increased reliance on online approval or rejection

Phobia Therapies

Behavioral approaches (e.g., systematic desensitization, flooding, and modeling) and cognitive approaches (e.g. identification and modification of beliefs)

Biological, Psychoanalytic, and Exposure Therapies

Biological: medication (benzodiazepines and SSRIs) can suppress symptoms but have dependence risks
Psychoanalytic: focuses on unconscious conflicts
Exposure: gradually exposes people to the feared stimulus while managing misinterpretations

Anxiety Part 2: Panic Attack and Disorder

Sudden episodes of intense fear accompanied by physical symptoms (e.g., labored breathing, heart palpitations)
Can occur with or without a trigger
Comorbid with depression and substance abuse
Possible biological influences involving neurochemicals such as norepinephrine (NE) and GABA

Etiology of Panic Disorder

Biological factors include physical conditions and genetics.
Cognitive theories suggest that misinterpretations of bodily sensations create a vicious cycle of anxiety and panic

Generalised Anxiety Disorder (GAD)

Characterized by persistent, uncontrollable worry about everyday issues, difficulty concentrating, muscle tension, fatigue and restlessness
Often linked to low SES in higher-income countries.

Treatments for GAD and Panic Disorder

Medications provide symptom management
Psychotherapies, like CBT, address maladaptive thought patterns and intolerance to uncertainty.

Schizophrenia Overview

Affects attention, perception, emotion, motivation, and thought processing; categorized into positive, negative, and disorganized symptoms
Is a complex heterogeneous disorder

Historical Perspectives

Kraepelin identified dementia praecox, emphasizing early onset and deterioration
Bleuler coined the term schizophrenia, focusing on associative threads and the potential for recovery
The shift toward psychological explanations from biological ones represents evolving conceptual theories

Diagnosing Schizophrenia

DSM-5 requires at least two Criterion A symptoms, one of which must be delusions, hallucinations, or disorganized speech.
Subtypes (paranoid, disorganized, etc.) from DSM-IV have been removed in DSM-5, emphasizing the variability in presentation

Schizophrenia: Prevalence, Onset, and Course

Prevalence is approximately 1% globally, varies by region and is common in late adolescence or early adulthood

Symptoms of Schizophrenia

Positive symptoms (hallucinations, delusions, disorganized speech or behaviour), negative symptoms (blunted affect, social withdrawal), cognitive symptoms (e.g., deficits in attention, memory, executive function).

Differential Diagnoses

Distinguished from mood disorders, substance abuse, and other psychotic (i.e., involving a loss of contact with reality) conditions
Requires consideration of duration, symptom consistency, and the presence of mood episodes

Cultural and Socioeconomic Factors

The prevalence remains consistent across cultures, although the presentation and the way that treatment is delivered may vary according to cultural influences
Factors such as urbanization and socioeconomic status (SES) can influence better prognosis in some populations

Outcomes and Comorbidity

High comorbidity with substance use, mood disorders, and personality disorders
Rules of thirds of prognosis: 1/3 improve, 1/3 stabilize, 1/3 deteriorate

Treatments and Care of Schizophrenia

Effective treatment requires a bio psychosocial approach.
Treatments include medications (Typical and Atypical antipsychotics) combined with psychological support, social or community-based interventions to better address the complex needs of the patients.
Additional emerging treatments to address schizophrenia include Avatar, and Open Dialogue Therapies

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Description

Explore the diverse views of wellness from over 50 Indigenous Nations, highlighting the interconnectedness of physical, emotional, mental, and spiritual dimensions. This quiz contrasts Indigenous knowledge with Western approaches to mental health, emphasizing balance, community, and the sacred relationship with the earth.