Mental Health Chapter 1 PDF

Chapter 1 Mental Health and Mental Illness Copyright ©2023 F.A. Davis Company Introduction § The concepts of mental health and mental illness are culturally defined. § Individuals experience both physical and psychological responses to stress. Copyright ©2023 F.A. Davis Company Mental Health § Conce...

Chapter 1 Mental Health and Mental Illness Copyright ©2023 F.A. Davis Company Introduction § The concepts of mental health and mental illness are culturally defined. § Individuals experience both physical and psychological responses to stress. Copyright ©2023 F.A. Davis Company Mental Health § Concepts identified by Maslow A “hierarchy of needs” Self-actualization as fulfillment of one’s highest potential § Mental health definition “Successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate and congruent with local and cultural norms.” Discuss the different parts of Maslow’s hierarchy (Physiological, Safety, Love/belonging, Esteem, and Selfactualization) and how they relate to each other. Note the characteristics that Maslow believed self-actualized individuals possess: An appropriate perception of reality The ability to accept oneself, others, and human nature The ability to manifest spontaneity The capacity for focusing concentration on problem-solving A need for detachment and a desire for privacy Independence, autonomy, and a resistance to enculturation An intensity of emotional reaction A frequency of “peak” experiences that validate the worthwhileness, richness, and beauty of life An identification with humankind The ability to achieve satisfactory interpersonal relationships A democratic character structure and a strong sense of ethics § § Creativity Copyright ©2023 Company F.A.ADavis degree of nonconformance Mental Illness § Horwitz describes two elements that affect how individuals view mental illness: Incomprehensibility: This is the inability of the general population to understand the motivation behind the behavior. Cultural relativity: The “normality” of behavior is determined by the culture. Copyright ©2023 F.A. Davis Company Mental Illness (continued) § Defined as “maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are incongruent with the local and cultural norms, and interfere with the individual’s social, occupational, and/or physical functioning.” Copyright ©2023 F.A. Davis Company Physical Responses to Stress § Hans Selye defined stress as “the state manifested by a specific syndrome which consists of all the nonspecifically induced changes within a biologic system.” This syndrome has come to be known as “fight-orflight” syndrome. Copyright ©2023 F.A. Davis Company Physical Responses to Stress (continued_1) § Selye’s general adaptation syndrome has three distinct stages: Alarm reaction stage:Fight-or-flight syndrome responses are initiated. Stage of resistance: Using the physiological responses of the first stage, the person attempts to adapt to the stressor. If adaptation occurs, the third stage is prevented or delayed. Physiological symptoms may disappear. § Stage of exhaustion: The adaptive energy is depleted, and diseases of adaptation may ensue. Biological responses associated with fight-orflight can include immediate responses (release of norepinephrine and epinephrine, increased respiration rate, increased heart rate, etc.) and sustained responses (increased gluconeogenesis, increased basal metabolic rate, decrease in secretion of sex hormones, etc.). Copyright ©2023 F.A. Davis Company Practice Question 1. A 25-year-old man barely avoids a motor vehicle accident. His heart is pounding, his palms are sweaty, and his respirations are increased. This is an example of which stage of the general adaptation syndrome? A. B. C. D. Alarm reaction stage Stage of resistance Stage of exhaustion Stage of biological stress Copyright ©2023 F.A. Davis Company Practice Answer Correct Answer: A The physiological responses of the “fight-or-flight syndrome” are initiated in the alarm reaction stage of the General Adaptation Syndrome. These physiological responses generally include an increase in heart rate and respirations and may include other symptoms such as headache, sweaty palms, and a sensation of dizziness. Copyright ©2023 F.A. Davis Company Physical Responses to Stress (continued_2) § Biological responses associated with fight-or-flight syndrome Immediate response: Dilation of the pupils Dilation of the bronchioles and increased respiration rate Increased force of cardiac contraction, which causes increased cardiac output, heart rate, and blood pressure Decreased gastric motility and secretions Increased secretion from the sweat glands Other responses Copyright ©2023 F.A. Davis Company Physical Responses to Stress (continued_3) Sustained physical responses to stress occur after a prolonged period of stress and promote susceptibility to many diseases of adaptation. : Increased gluconeogenesis and retention of sodium and water (ACTH) Decreased immune and inflammatory responses (ACTH) Fluid retention (vasopressin) Increased blood pressure (vasopressin) Increased serum glucose and free fatty acids (growth hormone) Increased basal metabolic rate (thyrotropic hormone) Impotence and decreased libido (gonadotropins) Copyright ©2023 F.A. Davis Company Physical Responses to Stress (continued_4) § The fight-or-flight response was useful for our ancestors. § However, it also occurs in response to psychological or emotional stimuli. These stressors are often not resolved as rapidly as some physical stressors. Modern stress has been described as a psychosocial state that is pervasive, chronic, and relentless. ‒ This promotes susceptibility to diseases of adaptation. Copyright ©2023 F.A. Davis Company Psychological Responses to Stress § There are two primary psychological response patterns to stress: anxiety and grief. § A variety of thoughts, feelings, and behaviors are associated with each of these response patterns. § Adaptation is determined by the extent to which the thoughts, feelings, and behaviors interfere with an individual’s functioning. Copyright ©2023 F.A. Davis Company Anxiety § A feeling of discomfort and apprehension related to fear of impending danger. The individual may be unaware of the source of their anxiety, but it is often accompanied by feelings of uncertainty and helplessness. § Anxiety is extremely common in our society. § Mild anxiety is adaptive and can provide motivation for survival. Copyright ©2023 F.A. Davis Company Peplau’s Four Levels of Anxiety § Mild: Seldom a problem. Prepares people for action. It sharpens the senses, increases motivation for productivity, increases the perceptual field, and results in a heightened awareness of the environment. Learning is enhanced, and the individual is able to function at their optimal level. § Moderate: Perceptual field begins to diminish. Extent of the perceptual field diminishes. The individual becomes less alert to events occurring within the environment. Attention span and the ability to concentrate decrease, and assistance with problem-solving may be required. Increased muscular tension and restlessness. § Severe: Perceptual field diminishes greatly. : Perceptual field diminishes greatly; concentration centers on one particular detail only or on many extraneous details. Attention span is extremely limited; the individual has much difficulty completing even the simplest task. Physical symptoms may include headaches, palpitations, and insomnia. Emotional symptoms may include confusion, dread, and horror. Virtually all overt behavior is aimed at relieving the anxiety. § Panic: The most intense state. The individual is unable to focus on even one detail within the environment. Misperceptions are common, and a loss of contact with reality may occur. Hallucinations or delusions may be present. Behavior may be characterized by wild and desperate actions or extreme withdrawal. Human functioning and communication with others are ineffective. The individual may be convinced they have a life-threatening illness or fear they are “going crazy,” are losing control, or are emotionally weak. Prolonged panic anxiety can lead to physical and emotional exhaustion and can be life-threatening. Copyright ©2023 F.A. Davis Company Adapting to Levels of Anxiety § At the mild level, individuals employ various coping mechanisms to deal with stress. A few of these include Eating Drinking Sleeping Physical exercise § Coping skills are coping behaviors that enhance one’s adaptation. Copyright ©2023 F.A. Davis Company Adapting to Levels of Anxiety (continued_1) § At the mild to moderate level, the strength of the ego is tested. § Ego defense mechanisms are employed for protection. Copyright ©2023 F.A. Davis Company Ego Defense Mechanisms § § § § § § § § Compensation Denial Displacement Identification Intellectualization Introjection Isolation Projection Copyright ©2023 F.A. Davis Company § § § § § § § Rationalization Reaction formation Regression Repression Sublimation Suppression Undoing Practice Question 2. A client hates her mother because of childhood neglect. Which of the following client statements does the client’s nurse feel represents the use of the defense mechanism of reaction formation? A. “I don’t like to talk about my relationship with my mother.” B. “My mother hates me.” C. “I have a very wonderful mother whom I love very much.” D. “My mom always loved my sister more than she loved me.” Copyright ©2023 F.A. Davis Company Practice Answer Correct Answer: C The client hides her negative unacceptable feelings through an exaggerated expression of positive feelings. This is an example of the defense mechanism of reaction formation. Copyright ©2023 F.A. Davis Company Adapting to Levels of Anxiety (continued_2) § Anxiety at the moderate to severe level that remains unresolved over an extended period can contribute to a number of physiological disorders, including cardiovascular, gastrointestinal, neoplastic, neurological, and pulmonary conditions. § Extended periods of repressed severe anxiety can result in psychoneurotic patterns of behaving. Copyright ©2023 F.A. Davis Company Neurosis § Common characteristics of individuals with neuroses include the following: They are aware that they are experiencing distress. They are aware that their behaviors are maladaptive. They are unaware of any possible psychological causes of the distress. They feel helpless to change their situation. They experience no loss of contact with reality. Copyright ©2023 F.A. Davis Company Adapting to Levels of Anxiety (continued_3) § Neurosis is a term used to describe the symptoms of certain disorders. § A neurosis is a psychiatric disturbance characterized by excessive anxiety that is either expressed directly or altered in expression through defense mechanisms. § The symptoms are significant enough to impair a person’s functioning, although there is no gross distortion of reality. Copyright ©2023 F.A. Davis Company Adapting to Levels of Anxiety (continued_4) § Extended periods of functioning at the panic level of anxiety may result in psychosis. § Examples of psychotic disorders include schizophrenia, schizoaffective disorder, and delusional disorder. Copyright ©2023 F.A. Davis Company Psychosis § Common characteristics of individuals with psychoses include the following: They exhibit minimal distress. They are unaware that their behavior is maladaptive. They are unaware of any psychological problems. They are exhibiting a flight from reality into a less stressful world or into one in which they are attempting to adapt. Copyright ©2023 F.A. Davis Company Grief § Subjective state of emotional, physical, and social responses to the loss of a valued entity Loss may be real or perceived. § Five stages of grief Denial Anger Bargaining Depression Acceptance Copyright ©2023 F.A. Davis Company Grief (continued_1) § Grief can be triggered by loss or anticipated loss. § The period of grief-related emotions and behaviors is called mourning, and the duration of this process varies by person and situation. Copyright ©2023 F.A. Davis Company Grief (continued_2) § Grief is not considered a mental illness. § The “normal” mourning process, which may include feelings of sadness, guilt, anger, helplessness, hopelessness, and despair, is adaptive. § However, maladaptive responses to grief may culminate in clinical depression or other symptoms of mental illness, including risk for suicide Copyright ©2023 F.A. Davis Company