Behavioural Science Notes Part 2 PDF

1 Week 9-Language and Thinking  Part 1: Introduction to Language 1. Phonemes: These sounds are put together in speech to create meaningful sentences. It includes vowels & consonants, but they also include the different ways of pronouncing them. 2. Morpheme: Smallest unit of meaning in languag...

1 Week 9-Language and Thinking  Part 1: Introduction to Language 1. Phonemes: These sounds are put together in speech to create meaningful sentences. It includes vowels & consonants, but they also include the different ways of pronouncing them. 2. Morpheme: Smallest unit of meaning in language. It can be a word itself of a word that contributes meaning. Two classification: assifications:- Free morphemes: can stand alone as words. - Bound morphemes: cannot stand alone as words.It must be attached to a free morpheme to convey message. E.g.: prefix ‘un’ in unhappy or suffix ‘s’ in dogs. 3. Phrases: morphemes are then combined into phrases, so groups of words that convey meaning. 4. Sentences: phrases are then organised into sequences that convey a thought or a message or request. E.g.: two phrases ‘the boy’ & ‘hit the ball’ becomes ‘The boy hit the ball.  2  Elements of language* Syntax: rules governing sentence structure. - It is how we arrange words in a way that makes sense. Semantics: relates to the meaning of words & sentences. - This involves how we interpret a sentence. Pragmatics: the context of the sentences. Discourse: the use of language & communication beyond individual sentences. - It involves how sentences & utterances are structured to form these coherent & meaningful conversations that we have. - - They focused on how ideas are organised, connected & interpreted withing a larger context. Top-down vs bottom-up processing: Top-down: Sensory information is interpreted in the light of existing context, expectations, and prior knowledge to understand language. - Refers to how our background knowledge, our expectations & context influence our understanding of language. - The process starts with a larger understanding or hypothesis about what is being communicated. Then we use that framework to interpret individual words or sounds. - Bottom-up: Individual elements like sounds or letters are combined to form a unified perception. - It uses the smallest unit being phonemes to gradually build a meaning. - The approach starts through comprehension with sensory input such as hearing sounds or saying written letters.  3 - From there the brain assembles that information to form a coherent understanding. Both processes often work together in real in life communication to help us efficiently interpret & respond to language.  Nature or nurture? ↬ Nature: language development is genetic predisposed Chomsky - Humans are born with an innate ability to acquire language. Universal Grammar - A set of grammatical principles shared across all languages, which he suggested is hardwired into the brain. Language acquisition device (LAD) - Chomsky also proposed that children are born with a mental mechanism (LAD), that allows them to automatically pick up rules of language when exposed to linguistic input. Critical Period Hypothesis - There is a specific window early childhood when the brain is especially receptive to language learning. - After this period,acquiring a language especially at a native level becomes much harder. ↬ Nurture: language development is primarily influenced by environmental factors & social interactions: Skinner - Emphasise the role of imitation & reinforcement  4 Vygotsky - Learning through social interaction Learning through social interaction - Children acquire language by interacting with caregivers & others in their environment. - So,imitate the speech they hear & through reinforcement such as praises or repetition, they learn how to use language correctly. Social Interactionist Theory - Suggests that language is learned through meaningful social interactions. - Adults can scaffold language learning by adjusting their speech & guiding children in understanding/using language. Language development in Infancy  5 Part 2: Introduction to Thinking and Cognitive Processes  Units of thought: * ↬ Thinking is how we process & manipulate information to solve problems/make decisions.  6 Concepts: mental groupings of simple similar objects, events or people + helps us to generalise, helping to streamline our thought processes. Categorisation: the process of identifying an object as an instance of a category, so recognising how it is either similar or dissimilar to others. Allows us to classify objects or people as being so suitable. Propositions: to know where things are placed/positioned Mental images: help us stimulate experiences & think about situations even when they are not physically present. Mental models: internal representations of how things work in the real world (e.g. mental model of how a car engine works or how to solve a math problem). Schemas: cognitive frameworks that help organise & interpret information. Allows us to categories new experiences based on prior knowledge, making it easier to then navigate new situations. Theory of mind: the ability to understand that other people have their own thoughts, feelings and intentions than us. So, it involves recognising that others have perspective and mental states that influence their behaviour.  Reasoning, problem solving, and decision making: * Reasoning refers to the process by which people generate and evaluate arguments and beliefs and typically try to solve problems.  7 Deductive Reasoning: The test * ↬ Each card has the person’s age on one side & whether he or she is drinking on the other side.  8 ↬ Card one and three should be flipped to ensure the law is being followed. ↬ Card holder number one need to be flipped to see if he/she is over 18. ↬ Card holder number three need to be flipped to see what type of drink they are having. Deductive reasoning Deductive reasoning starts with an idea rather than an observation – it starts with general principles and then makes inferences about specific instances. For example, if you understand the general premise that all dogs have fur, and you know that Monty is a dog, then you can deduct that Monty has fur, even though you have never made Monty’s acquaintance. This kind of deductive argument is referred to as a syllogism – it consists of two premises that lead to a logical conclusion if it is true that : a. all dogs have fur and b. Monty is a dog, then there is no choice but to accept the conclusion that c. Monty has fur  9  Problem Solving * ↬ Algorithms: step by step procedures that guarantee a solution (e.g. following recipe) ↬ Mental simulations: involve imaging & mentally rehearsing different scenarios or actions to predict outcomes before engaging in real world task (e.g. planning how to arrange furniture in your living room before physically moving the furniture). ↬ Barriers to problem solving: Functional fixedness- cognitive bias that limits a person’s ability to see objects beyond their typical or traditional use (fixed on the primary function of an object but fail to recognise alternative uses + hinders creativity). Mental set- the inclination to keep on using the same techniques that have worked in the past + failing to recognise when better alternatives should be obvious. Confirmation bias- where people tend to seek out, interpret & remember information in a way that confirms their pre-existing beliefs or opinions. May lead to people to overlook or dismiss evidence that contradicts their views.  10 Problem solving, and decision making: Stages* 11  12 Example of how the stages are used* 13  14 Decision making  Heuristics:  15 - Mental shortcuts or simple rules of thumbs that people use to make decisions/solve problems quickly & efficiently. Availability heuristic: the tendency for people to estimate the likelihood of an event based on how easily examples come to mind. So, if something is more memorable or recent, it feels more common. Representative heuristic: when we make judgements based on how much something resembles a typical case or stereotype. Anchoring heuristic: tendency to rely heavily on an initial piece of information or the anchor when making decisions or judgements. E.g. in negotiations the person first mentions a set of anchors & that affects how the price is determined. Part 3: The Interplay between Language and Thinking Language and Thought: Core Theories The Whorfian Hypothesis *  16 - The language we speak influences how we perceive & understand the world. - An example of this colour perception. - In some languages like Russian, there are multiple words for different shades of blue. - This may lead speakers to distinguish these colours more easily compared to speakers of language like English, where there is only one word blue that is commonly used. - Whorfian hypothesis does not support all cultures - E.g. New Guinea have only two basic colour words. - Molar= bright & Millie=dark, cold shades. - Did a test, where they hypothesised that English speakers would perform better when the chip was a basic colour with a primary name in their language like bright red instead of intermediate shade like magenta or taupe= this was supported. - Danish participants were also able to correctly identify basic colours more often than the less distinct shades, despite their language having no specific names for these names. Chomsky’s Universal Grammar * -We were born with an inherent ability to understand & develop language which grows out of our cognitive structures. Innate Language capacity: biologically programmed with a mental framework for understanding & producing language & this ability is part of our genetic makeup/present in all human cultures. Shared grammatical structures: these shared principles form basis of universal grammar & explain why children learn language quickly & easily. Language Acquisition Device: learn set of rules, natural process. Critical Period Hypothesis: critical period in early childhood when brain is the most receptive to learn language.  17  Explicit vs. Implicit Cognition* ↬ Explicit cognition: Involves the conscious deliberate thought. - When trying to solve a math problem or analyse text, you're engaging in explicit cognition. - Relies on language as we used words to frame & organise our thoughts. - E.g. verbal reasoning explaining a problem out loud or using language to lay out steps in a logical sequence. ↬ Implicit cognition: refers to the unconscious automatic process we have - For example, when you quickly recognise a face in a crowd/have a gut feeling about something. - So, non-verbal reasoning like mental imagery or spatial thinking tends to rely on implicit cognition. -Explicit= verbal reasoning - Implicit Cognition= non-verbal reasoning Language, Thought, and Culture* Cultural differences in language Representations in time Mandarin vs English - Mandarin-describes time vertically, up for earlier or down for later. - English- time is described as moving on a horizontal plane, forward into the future or backward into the past. Pormpuraaw people (Boroditsky & Gaby, 2010)  18 - Pormpuraaw people (remote First Nation community on Cape York Peninsula), arrange time according to the cardinal directions of East & West. -Time flows relating to the body= left to right is facing south or right to left is facing north. Bilingualism & multilingualism Cognitive flexibility- can easily allow them to switch between different linguistic systems that strengthens their ability to adapt to changing situations& solving problems. Emotional expression-studies show that people who feel a stronger emotional connection to their native language well may approach these topics more analytically in their second language. Module Summary ↬ Language: Elements Development of Language ↬ Thinking and Cognitive Processes: Units of thought Reasoning, problem solving, and decision making ↬ Interplay between Language and Thinking: Core Theories Language, Thought, and Culture  19 Week 10: Motivation & Emotion Part 1: Motivation What is motivation? * Motivation = the "Why" of behaviour: ↬ “Motivation refers to the “why” of behaviour, not the “how.” Why do we engage in certain behaviours and have certain feelings and thoughts but not others?” (Deckers, 2010, p.xvii). ↬ Motivation refers to the driving force behind behaviour that leads us to pursue some things and avoid others (Burton, Westen & Kowalski, 2023) Motivation is the concept we use to describe: ↬ Forces acting on or within an organism to initiate and direct behaviour ↬ Differences in the intensity of behaviour ↬ Persistence of behaviour Common view: 'Different perspectives' in motivation *  20 Each provides important contributions to understanding motivation, but… Messy… overlapping descriptions and approaches to understanding a single concept Why this approach from ‘different perspectives? 21 22  23 Psychology - a young and disintegrated science Psychology is a young science ↬ 1879 - Opening of Wilhelm Wundt's laboratory, University of Leipzig Multiple 'schools of thought' ↬ Historical schools in psychology ↬ Ongoing legacy in present psychological 'fields' ↬ Overlap in subject matter across the fields ↬ ‘Different perspectives’ approach Can there be a more integrated approach? ↬ Motivation of central relevance to most areas in psychology ↬ Ideal opportunity for an integrated approach ↬ To complement the different perspectives approach, let’s explore one way to bring these perspectives together… What do we study in psychology? Psychology is: ↬ Traditional definition: The science of ‘mind’ & 'behaviour‘or ‘mental processes and ‘behaviour’ Disjointed- does not explain the interaction or the relationship between mind & behaviour. Leaves out important aspects- overt observations  24 ‘Mind’ not adequately defined Martin's definition: The study of the functional interaction between nervous systems and their environments Nervous system and environments: * Nervous system: referred to the both the central & peripheral nervous systems. Includes the brain, spinal cord, automatic nervous system, sympathetic & parasympathetic nervous system & all the peripheral sensory & motor neural connections. 1. Everything outside our body/information from external environment is received by the nervous system. - Does this through the activation of our sensory mechanisms, eyes or ears. 2.The nervous system can also trigger responses that affect the external environment through activation of skeletal muscles. Move our legs & arms. - This is done by manipulating our environment in some way such as our manipulating our vocal cords or our lungs to be able to express language verbally.  25 3. The nervous system also interacts with our internal bodily/somatic environment also referred as endogenous environment. - The nervous system receives endogenous sensory inputs form a variety of internal sensory mechanisms. - For example, glucose receptors, where these receptors measure the amount of glucose in our bloodstream. - Proprioceptive- receptors that are embedded in our muscles, giving us feedback about the movement of those muscles. 4. The nervous system also responds in order to alter the internal bodily environment. - It has mechanisms that might release hormones into the bloodstream or that might regulate our internal organs. - E.g.: changing our heart rate or increasing/decreasing respiration rate. Questions to explore… 1.Response mechanism Simple instinctual/reflexive response system? Generalised response system (emotions, drives)? Conscious decision/plan to act? 2.Input/sensory mechanism Simple sensory detection? Object recognition/semantic memory? Personal (episodic) memory? Self-conscious/abstract belief?  26 3.How did the two become connected? Note: connection between the two denotes the ‘relevance’ or meaning of the stimulus to the organism. Note: Connection underpins the function of the entire psychological process. Part 2: Mechanisms of motivation* Much discussion in motivation theory focusses on systems that coordinate behavioural patterns (drives, emotions, etc.) Two important distinctions used to categorise motivational systems ↬ Respond mostly to internal bodily stimuli vs external stimuli/memories/beliefs ↬ Hedonistic vs homeostatic goal Internal vs external motivators * External motivators: ↬ Behaviour triggered by something in the external environment Internal motivators: ↬ Behaviour triggered by an internal 'need' or 'drive’ (often connected to a bodily state) - Bodily state for example can be hunger drive, where mechanism detected glucose in the bloodstream to be low. This then triggers the internal hunger drive. Typical pattern in both is that:  27 ↬ an environment is judged as non-optimal ↬ responses triggered to attempt to optimise environment (Not uncontroversial, but commonly used distinction) Hedonism vs Homeostasis* Hedonism ↬ Stimulus is: Good = want more Bad = want less Typically (but not always) have a set affective valence (pleasurable or unpleasurable feeling/sensation) + emotions like fear, disgust & anger Homeostasis ↬ Maintenance of a state of equilibrium ↬ Affective valence of stimulus context dependant ↬ Instead of good or bad, it depends upon the extent to which we have moved away from the sense of equilibrium. ↬ So, if we have too much of something or too little of something, it moves into a negative state where we have the motivation to produce a behaviour to get the system back into equilibrium.  28 Types of motivational system Primarily internal or external triggers? Have primarily hedonistic or homeostatic aims?  29 Part 3: Emotions Defining emotions* What is emotion? Yet to be adequately defined Folk psychology (everyday use of the term) ↬ Emotion as 'feelings' (conscious 'feeling- states') Emotions in functional context ↬ “An emotion is an inferred complex sequence of reactions to a stimulus and includes cognitive evaluations, subjective changes, autonomic and neural arousal, impulses to action, and behaviour designed to have an effect upon the stimulus that initiated the complex sequence.” (Plutchik, 1984)  30 Basic vs self-conscious emotions How many emotions are there? Many different words used to describe emotional states Some similar, some different across cultures Primary/basic emotions (Ekman and colleagues 1960s): ↬ Anger ↬ Disgust ↬ Fear ↬ Happiness ↬ Sadness ↬ Surprise ↬ These emotions are a response to the external environment.  31 Secondary/social/self-conscious emotions: ↬ Pride ↬ Shame ↬ Guilt ↬ Embarrassment ↬These emotions that tend to respond to a more internal stimuli, particularly around higher levels of evaluation of self or self in a social context. ↬ We are reacting to the judgement we have made about oneself in social context. Self-knowledge of emotions and emotional regulation: ‘Head or the heart’? Do emotions always control our behaviour? No… Additional components of emotion ↬ subjective experience ↬ self-knowledge - Our beliefs of our emotional experiences. - Strongly influenced by our language & narratives around emotions & psychology. - Exposed to in culture & society in which we’ve been brought up.  32 Relevance to clinical work * Significant proportion of the work of practicing psychologists is assisting people to: ↬ Better regulate and manage automatic emotional reactions, by... ↬ Building their self-knowledge of their emotions, and then… ↬ Developing skills to regulate (calm and de-escalate) those emotions and maintain behaviours that will decrease emotional intensity over time. What Is Non-Verbal Communication Most of us are confident about our ability to read other people’s emotions  33 Although many parts of the body communicate feelings, we tend to concentrate on what the face tells us Facial expressions can be valuable cues for judging emotions, however, even people within the same culture may learn to express the same emotions differently. What Are Some Basic Reasons for Non-Verbal Communication? Three basic functions include: providing information regulating interaction expressing intimacy (e.g., Ekman & Friesnen, 196 Week 11: Psychopathology Part 1: Mental illness prevalence and impact Mental illness is extremely common Over their lifetime: Australian Bureau of Statistics (2020-2022) ↬ 42.9% people aged 16-85 had a mental disorder at some time  34 This lasted for 12+ months for: ↬ 21.5% people aged 16-85 ↬ 38.8% people aged 16-24 ↬Period of higher likelihood of more chronic mental health concerns. Breakdown by type: ↬ 28.8% have had an anxiety-related disorder (most common, very consistent) ↬ 19% have had a substance use disorder ↬ 16% have had an affective disorder (mood) In the last 12 months: Australian Institute of Health and Welfare (2024): ↬ 1 in 5 (22%) people aged 16-85 had a mental disorder ↬ 17% had an anxiety disorder ↬ 8% had an affective disorder (mood) ↬ 3% had a substance use disorder Impacts Functional impacts (HILDA survey, 2021) People with chronic mental illness ↬ 17% need help or supervision in daily life ↬ 59% = workplace difficulties ↬ 58% of students = difficulties with education  35 Suicide (Australian Institute of Health and Welfare, 2024) ↬ 3249 in 2022 ↬ Three times more than road fatalities ↬ Leading cause of death in 15-44 age group Economic impacts (Productivity Commission estimates, 2020) ↬ Mental illness and suicide cost the Australian economy $70bn/yr. Particular groups of concern (AIHW): Overall prevalence Young people ↬ Mental illness highest in 16-25 age groups, decreasing over time Aboriginal and Torres Strait Islander (2018-2019) ↬ Mental illness prevalence of 24% (vs 22%) but… ↬ Higher suicide rates: 4.6% of deaths in 2022 (vs 1.6%) LGBTQ+ reports of previous/current diagnoses (2019) ↬ 61% reported depression ↬47% reported anxiety Disability (2020-2021)  36 ↬ 33% adults with disability = high psychological distress in last week (vs 12%) Gender Females ↬ Higher rates of mental illness overall ↬ 2 x more hospitalisation for self-harm ↬ Higher rates of suicide attempts Males ↬ Significantly higher death by suicide ↬ M=7 per day ↬ F=3 per day Is mental illness getting worse? 37  38 Perspectives 39 40  41 Part 2: What causes mental illness? * Complex question you’ll revisit throughout psychology study Two key concepts… Nature vs nurture ↬ Nature = Predisposed/genetic propensity ↬ Nurture = Impact of negative life experiences (trauma, abuse/neglect, non-optimal parenting/family environment, etc.) Diathesis-stress model ↬ Diathesis = underlying vulnerability ↬ Stress = current/recent events activating the underlying vulnerabilities ↬ Diathesis + stress = illness ↬ Applies to physical and mental health ↬ The idea that people may have underlying vulnerability to develop a particular physical or mental health problem. ↬ Vulnerability may not necessarily show up in mental health problems or physical problems until it's been triggered to do so by some recent stressors of some kind. ↬ Diathesis + recent stress is often what’s required to result in a presentation of mental illness. Diatheses* Genetic pre-disposition: ↬ Seen in many disorders (schizophrenia, bipolar, depression, anxiety, autism spectrum disorder, attention-deficit hyperactivity disorder…)  42 ↬ Genetic components to the likelihood of developing those disorders. Epigenetic pre-disposition= combination of genetic factors & environmental factors: ↬What happens when environmental experiences determine which genes are getting switched on or off. ↬ Can develop quite early on during the development of an embryo and foetus, for instance while the mother is pregnant. ↬ Susceptibility to anxiety/stress, anger, etc. ↬ Research found that certain experiences, for instance, a parent might have in their life increases the likelihood that their children may have certain genes that are turned on that increases their susceptibility to anxiety and stress or anger etc. Negative experiences: In childhood: Adverse Childhood Experiences (ACEs) ↬ Childhood physical, sexual and emotional abuse ↬ Physical neglect and emotional neglect ↬ Exposure to family violence ↬ Parental substance use ↬ Parental mental illness ↬ Parental separation or divorce; and ↬ Parental incarceration ↬ In adulthood: Past trauma, other negative events Lead to: Diatheses create vulnerabilities, reactiveness and coping tools/strategies. Also, determine the coping mechanisms, so if a stressor is going to come up in our life, how are we going to react?  43 Stress* Anything that overwhelms our ability to cope Acute environmental stressors: Could include: ↬ Loss (loved one, job, mobility/ability, etc.) ↬ Recent traumatic event (disaster, war, accident, etc.) ↬ Anything else causing high stress ↬ Overwhelm us quickly Chronic environmental stressors: Could include: ↬ Ongoing relational conflict ↬ Financial stress ↬ Chronic pain or illness ↬ Workplace bullying ↬ Overwhelm us slowly Trigger vulnerabilities and reactiveness, and overwhelm coping tools/strategies  44 Nature: Genetic predisposition Nurture: Early/past negative experiences, acute & chronic stressors (stressors tend to be mostly environmental in nature). Both nature & nurture: Epigenetics ↬ A combination of nature & nurture spread across causing diathesis (underlying vulnerability), which is then triggered by a particular stressor= presentation of mental illness. Causes of recent increase? We don’t know. Many possibilities… Genetic/epigenetic? ↬ Unlikely, due to quickly rising rates  45 Early childhood environments ↬ Over-protective parenting of Gen Z’s? ↬ Smart phones/social media re-wiring brains? Acute and chronic environmental stressors ↬ Global stressors (war, climate change)? ↬ Increasing political polarisation (left vs right)? ↬ Severe economic inequality? (highest it has been) ↬ Phones = Fingertip access to ALL the bad news? Mental health causation is complex. Keep an open mind and follow the science. Part 3: What is psychopathology? * Definitions ↬ Text: Psychopathology = Problematic patterns of thought, feeling or behaviour that disrupt an individual’s sense of wellbeing or social or occupational functioning. ↬ WHO: Mental disorder = Clinically significant disturbance in an individual’s cognition, emotional regulation, or behaviour Interchangeable terminology? ↬ Psychopathology ↬ Mental illness/disorder ↬ Abnormal psychology ↬ Older term (pathologizing?)  46 ↬ Raises a question… what makes thoughts, feeling or behaviour ‘abnormal’? Ways to define ‘abnormal’? Objective symptoms * Description ↬ Mental illness = underlying physical abnormality - We can essentially diagnose identify symptoms objectively & diagnose/categorise different mental health problems based on those symptoms' presentation. ↬ Medical model - Illness like any other illness - Considers mental illness sort of like a physical illness, as we’re going to look for the symptoms & then place a label on the person based on that symptom presentation. ↬ Underpins DSM Pros:  47 ↬ Qualitative classification and standardised symptom descriptions aid research and communication= provides clarity for researchers & communication between health professionals. ↬ Describes some mental illness very well (specific symptoms) Cons: ↬ Can be stigmatising (mental illness is more subtle or complex than physical illnesses) = overlap between many different disorders. ↬ Fails to describe other mental illness well (diffuse/varied symptoms, e.g. depression) ↬ Implies single causality= essentially saying that if two people have the same mental health diagnosis, we're assuming there’s similar factors that have led to that diagnosis for those two people. ↬ However, there can be multiple complex individual factors that have led that person to be showing the symptoms they’re showing. Implies universality (definitions of mental illness vary across cultures and historical periods) = assumes that mental illnesses will show up universally across all cultures & time periods. Aside: Sociohistorical variation * Example: Homosexuality DSM-I (1952) ↬ Homosexuality classified as a ‘sexual deviation’. Ongoing research and activism to get this changed ↬ Alfred Kinsey (1947): Only 50% pop’n exclusively heterosexual ↬ Evelyn Hooker (1957): Homosexual men just as happy as heterosexual men  48 ↬ Challenged by gay rights activists, esp. after 1969 Stonewall riots DSM-III (1980) (3rd version) ↬ Removed as disorder Social values shift perspective on what is considered ‘normal’ by medical profession. ↬ If societal attitudes changing shifts what we think & what we want to label as mental health problem, we can see that defining abnormality in psychological space is complex. Thomas Szasz (1974) Mental illness = construct to encourage conforming to societal norms Cultural Context The distinction between normality and psychopathology has long been subject to debate Every society has its own concept of what is deemed normal or abnormal - and this is constantly changing What is considered normal in one context, may be considered abnormal in another The cultural context defines (mal)adjustment of human behaviour, which includes how people usually behave, think, feel, and relate in social interactions However, throughout most of its history, the area of psychopathology has neglected to address cultural diversity. Aside: Cultural variation* Types and classifications of disorders ↬ Culture bound syndromes  49 ↬ E.g. Hikikomori (Japan), Hwabyeong (Korea) Hikikomori (Japan)= characterised by the total sort of withdraw from society & a desire to seek external social isolation & confinement. Hwabyeong (Korea)= A mix of depressive symptoms & physiological agitation, feelings of guilt & feelings of unfairness that are thought to result from chronic repression of anger & frustration. Culture Bound Syndromes* Hikikomori (Japan): A Japanese culture-bound syndrome of social withdrawal The term was first coined in the late 1980s Refers to adolescents and young adults who isolate themselves at home, withdraw from most social engagement, such as work or school, and have almost no relationships with others (except family members and online contacts) for longer than 6 months Expression of disorders (symptoms) ↬ Culturally appropriate displays ↬ Different cultures have different rules on what is appropriate & not appropriate to present in terms of behaviour. Prevalence of disorders ↬ Specific cultural and societal triggers ↬ In different cultures you’re more likely to have one mental health presentation or in other cultures you might have a higher prevalence of other mental health presentations. Conception of the nature and causes of mental illness  50 ↬ Cause in the person or external? ↬ Traditional Aboriginal societies ↬ Unusual behaviour caused by magic (other tribes, evil spirits) and curses Statistical abnormality* ↬ Most psychological phenomena vary across individuals according to normal distribution. ↬ Most people have a midline level e.g.: a particular personality characteristic (extroverted vs introverted you are) ↬ This is then put on a scale and measure people on a scale ranging from low extroversion to high extroversion. ↬ Most people are somewhere in the middle (midline level) but there are a few people at the extremes at the tail ends of the normal distribution= people who have very high extroversion or very low extroversion.  51 ↬ Overall idea of statistical abnormality to identify mental health problems: if you have a thought, feelings or behaviour, look at its prevalence across society & people who are very low or very high on that, we can perhaps label those as statistically abnormal. Social maladjustment* Description: ↬ Judgement of interaction between an individual and their environmental context. ↬ We’re judging whether someone has a mental health problem or not by whether they do directly fit into social norms. ↬ Social norms define mental illness Pros: ↬ Accommodates cultural and historical variation Cons ↬ Suggests mental illness is entirely socially relative (no cross-culturally universal disorders?) =no consistency at all with disorders. ↬Just because you’re unusual within a society does mean you’re unwell. So, unusual does not imply unwell! Labels minorities as unwell ↬ Who defines the norms? ↬ Accommodates cross-cultural variation but not within/multi-cultural variation. Subjective unhappiness/distress* Description  52 ↬ Mental illness = subjective distress to your thoughts, feelings, or decisions/behaviours. ↬ When someone is experiencing a certain high level of distress & a particular thought or feeling or behaviour or decision that they were making them. Pros ↬ Common feature of many disorders ↬ Accommodates cultural and historical variation ↬ Affirming to the individual (you have a problem if you feel you have a problem) - As you feel you the distress or having a problem. Cons Subjective stress is not a symptom of every disorder (ASPD) Distress is common in non-disorder contexts. How to distinguish? ↬ How to tell the difference between normal distress vs a level distress that we can classify as something has gone wrong with you. E.g. grief vs depression vs prolonged grief disorder (new in DSM-5-TR, 2022)? ↬ How do you separate grief as a normal experience from depression as a mental health problem. ↬ Prolonged grief disorder= creates a clear separation that defines when grief becomes turns into depression or has gone long enough that we’re shifting out of that normal range & into that needs treatment & helping people with. Returning to the definition Definition ↬ Text: Psychopathology = Problematic patterns of thought, feeling or behaviour that disrupt an individual’s sense of wellbeing or social or occupational functioning.  53 Something is unusual about someone’s thoughts, feelings, or behaviour= come from a variety of sources: may be usual in statistical/cultural/medical contexts. + Impairment to either Subjective wellbeing (distress), or Social/occupational functioning Part 4: Diagnosis and the DSM Why do we need to diagnose mental illnesses? Cons of diagnosing* Can be stigmatising ↬ By the self, by medical profession, by workplaces, by friends/relatives - Can cause stigmatisation & discrimination within a workplace. Labels can prevent progress ↬ Resigned to or identify negatively with the diagnosis ↬ Assuming diagnosis implies permanence (not always the case) - May make the mental illness as a part of their character, which could prevent progress/moving forward in addressing those mental health concerns. Encourages assumptions ↬ “You have X, so I already know about you” ↬ Individual variation in symptom presentation and causation may be over-looked - Factors that have led someone to having a particular mental health issue might be overlooked once they have a label.  54 Pros of diagnosing* For the person, receiving a diagnosis can ↬ Validate their challenges: “↬ I’m not just making it up!” ↬ Relieve and normalise: ↬ “I’m not the only one” - It is a known thing & lots of people receive this diagnosis as well= normalises it. - ↬ Source of pride and community: ↬ Neurodiversity pride movement (ASD, ADHD) - Support and provide community around a particular diagnosis & celebrate the ways in which that diagnosis has its strengths for us/has positive qualities. Narrative changes: “My functional challenges are due to society, not me” Facilitates (primary advantages of diagnosis): Research into causes and treatments Selection of evidence-based treatment:  55 ↬ Pharmacological (drugs treatment) ↬ Selection of evidence-based therapies Communication between health professionals: Speed of information transmission ↬ Easily have a good sense of what’s wrong with a client. Consistency and continuity of care DSM and ICD* Major classification systems: ICD-11 (2022) International Classification of Disease WHO-endorsed common system for health problems DSM-5-TR (2022) Diagnostic and Statistical Manual of Mental Disorders Published and maintained by American Psychiatric Association Principal tool for mental health diagnosis in Australia DSM revisions: Revisions DSM-I (1952) DSM-II (1968) DSM-III (1980)  56 DSM-III-R (1987) DSM-IV (1994) DSM-IV-TR (2000) DSM-5 (2013) DSM-5-TR (2022) Updating to consider: Improved scientific understanding - Updates reflect improved nuanced understanding about these different conditions. Sociohistorical changes (type and prevalence of disorders) - Sociohistorical factors can shift overtime that alter our perspective on whether something should be considered a mental health problem. Improved understanding of cultural context - Cultural context that influences & lead to an improved understanding of mental health problems. Consistency with ICD groupings and labels - DSM & ICD in terms of groupings & labelling of particular disorders. Latest Updates DSM-5-TR  57 The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5- TR) was published in 2022. The DSM-5-TR includes a new diagnosis of prolonged grief disorder and new symptom codes that allow clinicians to indicate the presence or history of suicidal behaviour and non-suicidal self-injury. Over 70 modified criteria set. Considerations of the impact of racism and discrimination on mental disorders is integrated into the text DSM-5-TR: Major diagnostic categories*  58 ↬ Abnormalities in brain structures. ↬ Development of it reflects that fact that they’re often there right from birth (lifelong). ↬ Schizophrenia as the main category but with a range of similar & related disorders particularly those that show psychotic symptoms.  59 ↬ Main symptom is a shift mood between depressive symptoms & often between more manic symptoms. Notably depression, hypomania and/or mania, or alternating periods of each.  60 ↬ Depressive disorder category includes disruptive mood, dysregulation disorder & persistent depressive disorder (Timea). The common feature of these disorders is the presence of sad, empty, or irritable mood, accompanied by related changes that significantly affect the individual’s capacity to function. (e.g., somatic and cognitive changes in major depressive disorder and persistent depressive disorder) What differs among these disorders are issues of duration, timing, or presumed etiology. 61  62 ↬ Specific phobia: e.g.: animal phobias. ↬ Agrophobia: a fear of being in open spaces & put in public. Disorders where anxiety and excessive fear are the main symptoms. In anxiety disorders people experience frequent intense and irrational anxiety  63 ↬ A fixated set of obsessions on a particular thing & or a set of compulsions to perform a specific behaviour. ↬ PTSD is within this category & symptoms include deliberate efforts to avoid thoughts or feelings of the traumatic events,nightmare,flashbacks,diminished responsiveness to external world + psychological numbness. ↬ Persistent grief disorder currently added in this category in 2022.  64 ↬ Disorders that show symptoms of a break or closure of consciousness in certain situations, which is usually the result of extreme traumas + response to overwhelming psychic pain, individuals might separate themselves from the situation by experiencing themselves & their feelings as outside their bodies. ↬ Dissociative identity disorder= Multiple Personality Disorder in older DSM versions. ↬ Dissociative Amnesia= Loss of memory of a particular time/play of time/situation. Individuals may have a selective inability to remember what happened in a particular time. ↬ Depersonalisation/Derealisation= a sense of disconnection from self in many ways Dissociative disorders are characterised by disruptions in consciousness, memory, sense of identity or perception. Dissociative disorders are frequently found in the aftermath of a wide variety of psychologically traumatic experiences in children, adolescents, and adults In dissociative identity disorder, at least two distinct personalities exist within the person.  65 ↬ Physical symptoms that comes up with a psychological cause in some way + focus on people’s thinking patterns about their illness, as opposed to the disbelief that they are really sick. ↬ Somatic symptoms, illness & anxiety disorder/conversion disorder. ↬Manifests during childhood (rumination/avoidant/restrictive food intake disorder). ↬Manifests during adulthood (bulimia, anorexia & binge-eating disorder).  66 → Anorexia: individuals starves themselves, exercises excessively or eliminates food in other ways (vomiting) until they are at least 15% below their ideal weight. → Bulimia nervosa: binge eating-purge syndrome, individuals tend to eat large amounts of food then induces vomiting, uses laxatives or engages in some other forms to behaviour to purge themselves of calories. ↬ Getting waste products from the body. ↬Enuresis & Encopresis= related to peeing and pooping.  67 Disorders involving disturbances while awake or asleep. Individuals with these disorders typically present with sleep-wake complaints of dissatisfaction regarding the quality, timing, and amount of sleep. These disorders often result in daytime distress and impairment. ↬ Delayed ejaculation: premature ejaculation. ↬ Erectile disorder: erectile challenges such as problems with levels of desire or pain around sex.  68 ↬ Individuals who shows symptoms of defiance of violence & challenge to others. ↬ Oppositional defiant disorder & conduct disorder shown in both children & parents. Personality disorders are characterised by enduring maladaptive patterns of thought feeling and behaviour that lead to chronic disturbances in interpersonal and occupational functioning. These patterns deviate from cultural expectations.  69 ↬ Addiction- requires that those behaviours to pass some fairly stringent requirements. ↬ This where dementia sits. ↬ Neurocognitive disorders that are due to particular diseases are Alzheimer Parkinson’s & Huntington's disease. 70  71 ↬ Sexual disorder spectrum but includes unusual sexual interests & behaviours. ↬ Challenging views of this disorder: some argue that certain sexual behaviours & interests should be considered more part of natural diversity of sexual interests rather than being labelled as a disorder.  72 ↬ Other specific mental health symptoms & presentations that might not fall neatly into one of the other categories/other medical conditions of some kind. ↬ The range of disorders because of a particular medication someone has taken.  73 ↬ Useful additions to a diagnosis to inform people about what are some of the environmental experiences & factors that someone may have gone through that may go along with/contribute to mental health problems. Diagnostic process ↬ Each diagnosis has a list symptom that someone needs to be meet.  74 ↬ So, the person needs to meet all set of core symptoms criteria. ↬ E.g.: GAD criteria need to be met by showing at least six months' worth of these symptoms & that anxiety is showing up across many different areas of your life. Differential diagnosis: ↬ Symptoms often match more than one condition & the critical part of this process is to eliminate other possible explanations for symptoms. ↬ Those include the effects of particular substance/another medical condition or a range of other mental disorders (comorbidity).  75 Criticisms of the DSM ↬ There is no disorder as disorder is an illness or a condition that disrupts normal physical or mental functions. ↬ We do not know the causes behind a lot of the disorders that are listed in the DSM, as we only classify & group them together based on symptom presentation. ↬ Comprehensive systems: includes all of the research into the casual factors underpinning some of these different symptom presentations.  76 Week 12: Psychopathy Treatment Part 1: Mental health treatment in Australia Statistics on mental health treatment Australian Bureau of Statistics (2020- 2022) 17.4% 16-85 yr. olds had seen a health professional for mental health in last 12 months Gender breakdown ↬21.6% females= overall ↬ 12.9% males= stigma for males to seek help for mental health problems. Age breakdown-decreases over age ↬ 22.9% aged 16-34 ↬17.4% aged 35-64 ↬8.1% aged 65-85 Who provides treatment for mental health issues? Formal training and government registration required: Psychologists ↬ Generalist ↬ Generalist + specialist endorsement qualification (clinical, forensic, educational developmental, etc.)  77 Medical doctors ↬ General Practitioners ↬ Psychiatrists Other allied health professions with additional specialist training in mental health ↬ Accredited mental health social workers ↬ Accredited mental health Occupational Therapists= ↬ Psychiatric nurse= nurses can also gain accreditation to become psychiatric nurses. No government registration but training and professional accreditation available ↬ Counsellors ↬ Behaviour Support Practitioners ↬ Psychotherapists ↬ Coaches/mentors ↬Aboriginal and Torres Strait Islander health workers Each approaches mental health from slightly different assumptions and perspectives.  78 All about being a psychologist in Australia 79  80 Part 2: Treating mental health issues  81 Treating Psychopathology* Approaches to treatment are constrained by cultural norms and values and beliefs. The concept of what is abnormal or normal varies and is limited by the cultural context. When considering treatment, it is important to understand what works for whom There are a range of evidence-based therapies and interventions that are used to address psychopathology. Most mental health services throughout the world currently regard evidence based psychological treatments as best practice for treating mental disorders. Evidence based approaches to treat different disorders are outlined in the Australian Psychological Society (APS) resource – a literature review of evidence-based treatments for each disorder. Biological treatments – Psychopharmacological*  82 Biological treatments – Neuro-anatomical/physiological * ↬ Surgery: Example: Epilepsy, severe OCD Very rare nowadays ↬ Brain stimulation: Electro-Convulsive Therapy (ECT)-may be unethical/has issues with it. - Still used for chronic depression, where other treatment has failed to treat it. Transcranial Magnetic Stimulation (TMS)- paddles which are positioned strategically around the head, through electrical stimulation to increase electrical activity in targeted parts of the brain. Electrical implants- implanting electrical electrodes in particular parts of the brain, so people can control the amount of activation in that part of the brain. Counselling/practical supports*  83 ↬ Supports the clients to relieve some of the psychological symptoms they are experiencing. ↬ Address the stresses rather than the diathesis. ↬ Looks at the person’s life & going what are the actual practical problems in your life & what we can do to actually help with that? ↬ Advice: Financial issue, so the counsellor may help to find ways to help you get financial advice/ways to deal with that issue/problem that’s coming up your life. ↬ Social workers= becomes an advocate for a client & helps them. E.g.: helping with getting an appointment & service to help overcome client with systemic barries they face. ↬Psychologist= help build their internal self of agency capacity & resiliency. Psychological therapies*  84 ↬Stressors: The goal is not just to manage stressors in their environment but to also give the client the capacity that they’re safe to be able to work on the underlying causes/vulnerabilities that results in psychological symptoms when triggered by stressors of the person’s life. ↬ Diathesis: Focused more on diathesis & our goal here is to address the underlying vulnerabilities behind symptoms. Common way psychological therapies address diatheses * Understanding diatheses - Two types of psychological system ↬ Unconscious/Automatic: Fast, intuitive, emotion-based, dependent upon previous experiences/learning Include beliefs about the world/self, emotions, and motivate specific behaviours Some hard-wired (reflexes/instincts), many learnt from past experiences (good and bad). -Allows us to very quickly assess something that happens in our environment/some situation that we are exposed to.  85 - Assess if its good or bad-should be afraid or is it positive. - Ways to quickly judging & reacting to our world. Pros: Good for ‘quick and dirty’ effortless evaluation and reaction, e.g. ‘hungry tiger in front of you!’ (fight & flight system). Cons: Rigid/inflexible and narrow-focussed in how they understand and react to the world; see past experiences as 100% true. ↬ Conscious/Controlled: Slow, controlled, can access rationality/logical thinking Executive functioning/’frontal lobes’ Pros: Great for evaluating and changing behaviour; can think outside of past experiences (creativity, problem- solving); learning new behaviours (e.g. riding a bike) Cons: Slow and effortful (terrible if a hungry tiger is in front of you!!) Understanding diatheses – What are psychological vulnerabilities?* ↬ Psychological vulnerabilities = automatic systems that react to the world with patterns of thought, emotion, and behaviour that display as psychological symptoms ↬ Symptoms reflect Lessons learnt in the past that no longer apply More/less intense emotions than are functional for the situation (e.g. phobias)  86 Not knowing better ways to manage/ react to a situation Interpreting own psychology in unhelpful ways Common goal of most psychological therapies * 1. Recognise when automatic system is coming up. 2. Have positive narrative or understanding of that system. 3. Have a right values & goals in place to create a motivation to change. 4. Having some skills & making the right decisions in response to that automatic system. Example: Anger management  87 Psychodynamic Therapies: * The psychodynamic perspective on emotion asserts that people can be unconscious of their emotional experience. Some psychodynamic theorists also emphasise social and cultural factors more than Freud did According to psychodynamic theory, symptoms result primarily from three sources: 1. Maladaptive ways of viewing the self and relationships. 2. Unconscious conflicts and compromises among competing wishes and fears. 3. Maladaptive ways of dealing with unpleasant emotions. The Psychodynamic Approach: Issues and Debates:* Free Will vs Determinism: It is strongly determinist as it views our behaviour as mostly caused by unconscious factors over which we have no control.  88 The concepts proposed by Freud cannot be tested empirically and Freud’s theory is not falsifiable. If people behave in the way predicted by the theory, it is viewed as a support; if they don’t, it could be argued that they are using defence mechanisms. The scientific merit of psychodynamic therapies has been questioned; however, many therapists still use these therapies for a range of disorders, including Borderline Personality Disorder, Bulimia Nervosa, and Generalised Anxiety Disorder. Bachrach et al., (1991) suggests that psychoanalysis may not be appropriate for patients suffering from obsessive-compulsive disorder in that it may inadvertently increase their tendency to over-interpret events in their life. Psychodynamic Techniques* Free Association: A technique for exploring associational networks and unconscious processes involved in symptom formation. Interpretation: Helping the patient to understand their experiences in a new ligh.t Analysis of transference: Understanding how past relationships influence other relationships and the patient’s relationship with the therapist. Varieties of Psychodynamic Therapy* Psychoanalysis: The patient lies on the couch, so associations can come to their mind, and the analyst sits behind them – this is thought to facilitate the patient’s ‘disclosing’. They meet frequently (3-5 times a week). Psychodynamic psychotherapy: The patient and therapist sit face to face and the aim is to explore unconscious processes. Similar to psychoanalysis, however, the therapist and client are usually more goal directed as they meet less frequently (1-2 times a week). Part 3: Introduction to Psychological Therapies  89 Reminder: What psychological therapies do* Work in concert with… ↬ Biological treatments ↬ Counselling/practical supports To address the… ↬ Underlying vulnerabilities (diatheses) that make a client susceptible to developing a mental health diagnosis. Lots of different types of psychological therapy, but most address diatheses by ↬ Using conscious system to think or act differently to ↬ Change or better manage automatic systems that are maladaptive (i.e. underpinning symptoms) Recap: Four broad areas targeted by therapies*  90 What differs between therapies?* y.  91 - Does not address the root of the causes but focuses more on how to address these symptoms. - ↬ CBT (Cognitive behavioural therapy) & DBT (Dialectical behaviour therapy): - Very strong on helping clients to recognise when a system has been activated but quite weak on exploring a deeper sense of what this system is & what it means for the clients. - Would still explain to the client what is going on & try to create a framework for motivation but tend to focus strongly on the skills & actions clients are going to take to make the decisions they are taking to make an improvement. ↬ ACT: Acceptance of commitment therapy. - Medium level on recognising the automatic system being activated & building a clear understanding/narrative for the system means for the client. - Very strong on values & goals to create a sense of commitment/acceptance to act differently or improve. ↬ Schema (developed from CBT): Strong in all aspects of four broad areas targeted by therapies. ↬ IFS (internal family systems): - Strong in all three aspects expect for skills/decisions needed. - Strong in recognising the automatic system & very self-compassionate in the way that it helps a client to build an understanding of their psychology/goals & values. - Weak on the set of skills or tools client might use to then change the system. Evidence of efficacy ↬ Varies across therapies but strongest for CBT ↬ Training as a psychologist = strong foundation in evidence-based approaches =CBT ↬ Medicare rebates: Evidence-based therapies only  92 But… ↬ Evidence is of symptom improvement ‘on average’ ↬ Not all clients benefit from CBT ↬ Client experience of CBT is not always positive/clients often ‘want more’ (may be negative or need something different) ↬ Older therapies will naturally be more researched (60 years of research) ↬ Lack of evidence doesn’t imply a therapy is ineffective Easy to do research with CBT (standardised structured treatment packages) - It is a very amenable as a therapy to create a standardised, structured treatment package that many clients can go through the same process. 3rd/4th wave therapies more tuned to individual clients (difficult to establish therapy X is effective when the therapy looks different for every client) Third and fourth wave therapies developed in response to limitations (in approaches such as CBT). Cognitive-Behavioural Therapies* Typically, short term therapies (unlike psychodynamic therapies). ↬ They are not concerned with exploring and altering personality patterns or unconscious processes. ↬ The focus is on the individual’s present behaviour and cognitions (not on childhood experiences or inferred motives). ↬ Cognitive-behavioural therapists begin with a careful behavioural analysis: examining the stimuli or thoughts that precede or are associated with a symptom. ↬ They produce a case formulation with key information about client’s difficulties/strengths providing a framework to address problematic behaviours, cognitions and emotions. ↬ Case formulation is the basis of quality treatment  93 Cognitive-Behavioural Techniques* Panic attacks include physiological arousal, a subjective experience of terror, anxious thoughts and a tendency to avoid stimuli associated with anxiety. ↬ Panic patients come to associate autonomic reactions such as a racing heart and a feeling of suffocation with an impending panic attack. ↬ They also frequently develop expectancies of helplessness in the face of impending panic and may have catastrophic thoughts such as “I am about to die”. ↬ The therapist addresses different components of the problem with different techniques. ↬ These may include paced breathing exercises to deal with feelings of breathlessness, repeated exposure to the experience of a racing heart (e.g., going up and down stairs) etc. ↬ The earliest, and some of the most powerful techniques emerged from research on classical conditioning (e.g. desensitisation and exposure). Cognitive-Behavioural Techniques* Systematic Desensitisation: The patient gradually confronts a phobic stimulus mentally, while in a state that inhibits anxiety. Has been used to treat a long list of anxiety related issues including nightmares, social anxiety and obsessive- compulsive disorders. Exposure Techniques: Patients are presented with the actual phobic stimulus in real life, rather than having them merely imagine it. Is a successful treatment for phobias. One form of this is called ‘flooding’ - where the patient confronts the phobic stimulus all at once.  94 What does this mean for therapy today? * ↬ You learn each therapy as a whole sort of complete package. Like the process of administering CBT/ACT. ↬ Mix & match of therapies to see the ones effective for the client's need. ↬ Clients may have to try a set of different psychologists that have different training & focus in terms of their way to adapt to different therapies to find the right mix of therapies that is going to work for them.  95 Week 13: Health & Wellbeing Part 1: Health Psychology What is Health Psychology? * ↬ “Health psychology is devoted to understanding psychological influences on how people stay healthy, why they become ill and how they respond when they do get ill” ↬ Health psychologists may understand the causes of illness and provide treatment in areas relating to physical health and health related behaviours. They may help to promote positive health behaviours and manage health-compromising behaviours. Examples Treating depression in cancer patients Researching psychological factors contributing of obesity Providing advice to managing mental health in COVID-19 lockdowns Researching smoking behaviours Promoting safe sexual behaviours Informing public health policy Well-being* “A state of being comfortable, healthy or happy. An individual’s health and wellbeing is multidimensional, with environmental, social, biological, lifestyle, spiritual, vocational, societal and socioeconomic factors all interacting (AIHW, 2016a; APS, 2015).”  96 Biopsychosocial model* ↬ States that for help for health conditions & diseases to arise, you need to have the interactions of different factors. ↬ This includes biological, psychological & social factors. ↬ The idea that there are these three overlapping interacting domains that contribute to the health/mental health & wellbeing.  97 ↬ The idea that there are these three overlapping interacting domains that contribute to the health/mental health & wellbeing. Lifestyle-related illness:  98 Lifestyle choices and health-compromising behaviours are major contributors to the leading causes of death today. Type II diabetes increasing Health-related behaviours Health enhancing/promoting behaviours: ↬ Behaviours that improve health and health outcomes/prevent disease & illness overtime. Examples: Exercise Diet and weight control Stress management Self-care Health compromising behaviours: ↬ Behaviours that lead to poorer health and health outcomes Risky sexual behaviours Substance abuse Smoking Sedentary behaviours Technology over-use Models of Health Health belief model Theory of planned behaviour  99 Transtheoretical model Transtheoretical model ↬ States that that there are different stages that people go through when they choose to engage in a certain behaviour. ↬ That behaviour can be health enhancing or removing a health comprising behaviour. ↬This model can be applied to a range of different health behaviours such as quit smoking or drinking, start exercising & drinking more water. ↬ The idea that whenever we engage in health behaviours that is moving towards positive change, we go through these stages.  100 ↬ Relapse may occur in maintence but this model theorised that people will potentially go up & down these stages depending on where they were in the model. Part 2: Obesity Obesity in Australia ↬ Overweight and obesity rates are among the highest in the world, with 36 percent of Australian adults being overweight and 31 percent being obese. ↬ One in four children aged 2–17 was overweight (17 percent) or obese (8.2 percent) in a recent year (AIHW, 2020e). BMI-Body Mass Index* ↬ “Determining whether a person is overweight or obese is typically done by calculating the individual’s body mass index (BMI): weight in kilograms divided by height in metres squared: kg/m2 (AIHW, 2020e; Wadden et al., 2002). Overweight if they have a BMI between 25 and 30 percent, and obese if they have a BMI of over 30 percent; depending on their gender and age (AIHW, 2020e). Obesity thus refers to an excessive accumulation of body fat. However, the BMI is flawed because it takes no account of potential differences in muscle mass. Someone with a large amount of lean muscle mass will weigh more than someone of similar height without the muscle. Thus, they will be classified as being overweight, but they do not have more fat.” Physical problems associated with obesity* ↬ musculoskeletal difficulties  101 ↬ heart disease ↬ high blood pressure ↬ type 2 diabetes ↬ sleep apnoea and different types of cancer. Psychosocial consequences of obesity * ↬ Low self esteem ↬ Dissatisfaction with body shape ↬ Discrimination and isolation ↬ Depression ↬ Stigma may contribute to psychological effects of obesity Causes of obesity * Body fat is regulated by the hormone leptin. ↬ People with higher levels of leptin generally have higher BMIs (Friedman, 2000). ↬ Leptin is produced by fat tissue and operates on the hypothalamus to regulate body weight. “Susceptible gene hypothesis” ↬ Certain genes increase the likelihood of, but do not guarantee, the development of a particular trait or characteristics (e.g., obesity).  102 ↬ There might be interactions between genes & environment that could be contributing to the development of obesity in a lot of different people. Social factors associated with obesity ↬ SES (Socioeconomic status)- People who have higher income often have less prevalence rate of obesity/being overweight. Better access/quality of food. ↬ Environmental factors – diet and exercise (geographical) ↬ Availability and affordability of healthy foods- healthy food brought from different regions of a country can it very unaffordable to people on low incomes. ↬ Increase in sedentary jobs- many people’s jobs requires them to sit for a very long time (could be applied to studying/watching tv too) Societal changes More time indoors for children More time on games and higher screen time- less active outdoors.  103 Part 3: Exercise and physical activity Adult Recommendations* Adults should be active most days, preferably every day. Each week, adults should do either: 2.5 to 5 hours of moderate intensity physical activity – such as a brisk walk, golf, mowing the lawn or swimming. 1.25 to 2.5 hours of vigorous intensity physical activity (increasing heart rate) – such as jogging, aerobics, fast cycling, soccer or netball. an equivalent combination of moderate and vigorous activities. Include muscle-strengthening activities as part of your daily physical activity on at least 2 days each week. This can be: ↬ push-ups ↬ pull-ups ↬ squats or lunges ↬ lifting weights ↬ household tasks that involve lifting, carrying or digging. ↬ Doing any physical activity is better than doing none Exercise* ↬ Textbook: Australian Bureau of Statistics reported that in 2011–12, 66.9 percent of Australians were either sedentary or had low levels of exercise, albeit an improvement from the low levels of exercise seen in 2007–08 (ABS, 2011).  104 ↬ The 2014–15 survey found a small improvement, with approximately 56 percent of Australians undertaking the recommended level of physical activities each week (AIHW, 2016a). Australian Bureau of Statistics ‘Physical activity’ 27.2% of people aged 15 years and over met the physical activity guidelines in Australia. 73.4% of people aged 18-64 years undertook 150 minutes or more of physical activity in the last week. Nearly half (49.4%) of employed people aged 18-64 years described their day at work as mostly sitting. Type of exercise: * In 2020-21, half (50.9%) of people aged 15 years and over went walking for exercise, recreation or sport (excluding workplace activity) in the week prior to the interview. Females were more likely than males to walk for exercise (52.7% and 49.0% respectively). More than one in three (35.7%) people aged 15 years and over undertook moderate exercise, while 17.7% engaged in vigorous exercise One in three (32.5%) people 15 years and over reported completing strength or toning exercises and 46.0% reported walking for transport. Benefits of exercise* ↬ Muscular vigour will…always be needed to furnish the background of sanity, serenity, and cheerfulness to life, to round off the wiry edge of our fretfulness, and make us good-humoured and easy of approach (William James, 1899) Benefits in a range of health conditions and health overall:  105 E.g. improve cardiovascular health, managing cancer side effects, pregnancy, older adults, improving mortality Depression- improve mood/anxiety symptoms Improved cognitive functioning Reduce risk of obesity ↬ Exercise is theorised to help all organs in body by increasing blood flow to all areas. ↬ At a whole-body level, exercise increases aerobic capacity, so it increases insulin sensitivity, increases glucose control & oxidative capacity & decreases lipids. Increasing exercise Workplace health – programs, gym memberships. Workplaces can help to promote healthy lifestyles for employees. Schools and universities also good places where exercise can be promoted. Lifestyle Programs The Australian Government is committed to promoting healthy lifestyles through various and diverse initiatives such as:  106 Get Set 4 Life — Habits for Healthy Kids The Stephanie Alexander Kitchen Garden Foundation Healthy Spaces and Places Get up and Grow — Healthy Eating and Physical Activity for Early Childhood Part 4: Stress and Wellbeing What is Stress? * Stress: –A stimulus –A response ↬ Stimulus would be called a stressful response that people engage with the stress/unique ways they respond to it. –An interaction between an organism and its environment Stress: a pattern of cognitive appraisals, physiological responses and behavioural tendencies that occurs in response to a perceived imbalance between situational demands and the resources needed to deal with them. - Individuals become stress when they can’t handle/control it. Stress is a psychobiological process, with both physiological and psychological components and consequences. Almost everyone has experienced the sudden urge of adrenaline that comes with something unexpected. The experience of "stress", or anxiety, is a central human emotional state. There has been a great deal of psychological research that has attempted to link the experience of various stressful events to physical and mental illness.  107 Stress refers to challenges to a person’s capacity to adapt to inner and outer demands. Stress can be understood as a psychobiological process, with both physical and psychological components and consequences. For example, Selye’s general adaptation syndrome posits that due to stressful events the body responds with a syndrome consisting of three stages: alarm, resistance and exhaustion. Stress can also be understood as a transaction between the individual and the environment, rather than a property of either the person or the environment alone. For example, Lazarus’s model identifies two stages in the process of stress and coping: primary appraisal (evaluating a situation) and secondary appraisal (deciding what to do based on the options one has). Selye’s General Adaptation Syndrome Alarm: Involves the release of adrenalin and other hormones such as cortisol as well as activation of the sympathetic nervous system. This is what occurs biologically in fight-or- flight responses: blood pressure, heart rate, respiration and blood sugar rise as blood is diverted from the gastrointestinal tract to muscles and other parts of the body that may be called upon for an emergency response. Resistance: The parasympathetic nervous system returns respiration and heart rate to normal. However, blood glucose levels remain high (for energy) and some stress-related hormones (including adrenalin and cortisol) continue to circulate at elevated levels. Essentially, the organism remains on red alert, with heightened energy and arousal, but it has begun to adapt to a higher level of stress. Exhaustion: If the resistance phase lasts long enough, the body eventually wears down, and the organism enters exhaustion. Here, physiological defences break down, resulting in greatly increased vulnerability to serious or even life-threatening disease. Organs such as the heart that are vulnerable genetically or environmentally (from smoking and/or too much lifelong cholesterol intake etc.) are the first to go during this stage. Transactional Model of Stress  108 A major step forward in the study of stress came when Richard Lazarus developed his transactional model of stress. Lazarus’s model identifies two stages in the process of stress and coping: primary appraisal and secondary appraisal. In a primary appraisal of the situation, a person decides whether the situation is benign, stressful or irrelevant. If the person appraises the situation as stressful (e.g., the lecturer who fails to make tenure), they must determine what to do about it. In the second stage, secondary appraisal, the person evaluates the options and decides how to respond (e.g., deciding that they are better off leaving the university to work for an internet firm and make a better living). Types of stressors* Stressors: stimuli that place demands on us and require us to adapt in some manner. Micro stressors: daily hassles and minor annoyances. Major stressors: personal, negative events, acculturative stress. Catastrophic events: tend to occur unexpectedly and affect large numbers of people. 109  110 Catastrophic stressors*-big life events Bushfires Floods Cyclones ↬ Can lead to PTSD ↬ Can explain why we might get sick after exams as we have had a high resistance to cope with stress. ↬ This is because we have needed to use all our cognitive resources to cope with short term stress or we then find that our energy becomes depleted after we have managed that stress or moved to the other side. Stress and illness ↬ Stress can combine with other factors to influence physical illnesses.  111 Physiological responses to stressors directly harm body systems. Stress can cause people to behave in ways that increase the risk of illness- such as different maladaptive coping styles. Stress can have an impact on people’s negative affect. ↬ Part A: shows the relationship between the amount of physiological or psychological stress & the percentage of participants judged by doctors to have clinical cold after exposure to a virus. - The more people were stress, the more cold people are judged to present in clinical population. ↬ Part B: represents data from a biological test of participants blood, the presence of infection.  112 - For each of the five viruses, participants reporting higher stress also showed higher rates of infection. Pathways through which stress can impact our bodies 1. Stress directly leads to the CNS & endocrine changes. 2. So, this leads to the activation of the hypothalamus & the release cortisol/adrenaline, which leads to worse health practices. 3. This then increases our exposure to pathogens in the environment, which lower our bodily defences against diseases & illnesses. 4. This exposure to toxins & pathogens can then increase our vulnerability to diseases. 113 114  115 Stress & resistance to infection  116 ↬ Research in the past 20 years has identified mechanisms by which stress might affect the capacity of the individual to resist infection. When people experience stress, hormones cortisol, adrenaline and nor− adrenaline (called stress hormones) are released in the body. These hormones are partly responsible for the physiological changes (increase in heart rate, dilated pupils, rapid breathing, etc) associated with a stressful experience. These hormones influence the immune system (body’s defence mechanism). ↬ In addition, the sympathetic nervous system, which is activated in response to stress, directly affects the immune system. Generally, these physiological aspects of the stress response reduce the capacity of the immune system to resist an infection, such as a flu virus. Part 5: Resilience What is resilience? * Resiliency: ability to tolerate and thrive in highly stressful circumstances. Protective factors: resources that create resilience. Help people cope more effectively and include: ↬ Social support ↬ Physiological reactivity ↬ Coping skills/styles ↬ Personality Social support  117 Theories of social support* ↬ Buffering hypothesis “Social support is a buffer or protective factor against the harmful effects of stress during high stress periods.” - So, when individuals are stress,they have people around them to listen & help them. “Social support as a continuously positive force that makes the person less susceptible to stress in the first place. - People may have ongoing support that is meaningful & helpful. That means that you are much more/less susceptible to stress over time as well. - Quality of supports also matters. Beneficial support=the ones that you want & need.  118 Coping mechanisms* Coping mechanisms are the ways people deal with stressful events. Problem-focused coping involves changing the situation. - Problems that can be solved with a strategy, phone call or changing something to fix the problem. Emotion-focused coping aims to regulate the emotion generated by a stressful situation. - By using self-care techniques or different ways of changing your cognitive appraisal of how you think in a particular problem. ↬ Both types of mechanisms are beneficial for good coping. ↬ So, people who cope well have a range of problem focussed coping strategies & skills they use as well as a range of emotion focused coping strategies to help them cope with different stressors. Coping* The ways people respond to stress, as well as the situations they consider stressful, are in part culturally patterned. Members of minority groups who, for generations, experience a ceiling on their economic prospects because of discrimination sometimes develop a low-effort syndrome in which they seemingly stop making the kinds of active efforts that might alleviate some of their hardships (give up in making any changes). Coping self-efficacy*  119 Coping self-efficacy: belief that we can perform the behaviours necessary to cope successfully. Specific to the particular situation. How can we increase self-efficacy* 1.Self mastery 2.Vicarious experiences 3.Verbal persuasion 4. Physiological states ↬ How we think about the situation, how we prepare for a situation, how we think about ourselves in terms of preparation. Seligman Learned Optimism vs. Helpless/Hopeless* Learned Optimism: From childhood: whether you view yourself as valuable and deserving or worthless and hopeless (pessimistic). Explanatory style: The way we internally respond to good and bad events in our lives. Shapes & molds whether we have an optimistic or pessimistic style of approaching different problems or situations. Glass half full or half empty: Optimist vs. Pessimist. Optimistic explanatory style* ↬ Permanence: situation will be repeated (can do anything)  120 ↬ Pervasiveness: generalizing to another event (can then do other stuff as you already fulfilled something). ↬ Personalization: see self as causal agent (apply to a whole range of different situations). Developing and optimistic explanatory style* High optimism and succeeds: –Permanent –Pervasive –Internal High optimism and fails: –Temporary –Specific –External A person with a less resilient explanatory style* Low optimism and succeeds: –Temporary –Specific –External ↬ May think it is a one-off thing Low optimism and fails: –Permanent  121 –Pervasive –Internal