chapter 41 surgeon general's report: chapter 4 : adults and mental health by: erica bennett
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Chapter 4 1
Surgeon General's Report: Chapter 4 : Adults and
Mental Health
By: Erica Bennett
Chapter 4 2
Mental Health in Adulthood
The successful performance of mental function, enabling individuals to cope with adversity and to flourish in their educational, vocational and personal relationships.
This definition may be too narrow. 20% of the adult population has a
mental disorder.
Chapter 4 3
Factors of Mental Health
PERSONALITY TRAITS: Self-Esteem
Self-Efficacy Neuroticism Avoidance Impulsivity Sociopathy
Chapter 4 4
Factors of Mental Health
STRESSFUL LIFE EVENTS: Past trauma and child sexual
abuse Domestic Violence Interventions for Stressful Life
Events
Chapter 4 5
Factors of Mental Health
PERSONALITY TRAITS:
Personality traits are important because they are seen as being influential to mental health.
Can be beneficial or detrimental
Chapter 4 6
Factors of Mental Health
SELF-ESTEEM: Refers to a person’s belief of self
worth, competence and abilities. Buffers individuals from adverse
life events. Self-efficacy is the confidence in
one’s own ability to cope with adversity independently or with assistance from others.
Chapter 4 7
Factors of Mental Health
NEUROTISISM: Refers to a broad pattern of
psychological, emotional, and psychophysiologic reactivity.
High level = worry. Risk of early-onset of depressive
and anxiety disorders.
Chapter 4 8
Factors in Mental Health
AVOIDANCE: A predisposition to avoid situations
and see personal challenges as threats.
May be inherited and associated with shyness, anxiety and depressive disorders.
Chapter 4 9
Factors of Mental Health
IMPULSIVITY: Trait associated with poor control
of emotions, especially anger, difficulty delaying gratification and novelty seeking.
For children, impulsivity may predict later disorders in adulthood.
Chapter 4 10
Factors of Mental Health
SOCIOPATHY: Dishonest, hurtful, unfaithful and
dangerous behaviors that benefit the individual.
DSM-IV refers to it as an antisocial personality disorder.
Represented highly in prisons. More common among men.
Chapter 4 11
Factors of Mental Health
STRESSFUL LIFE EVENTS: Most common are:
Breakup of intimate romantic relationship. Death of a family member or friend. Economic hardships. Racism and discrimination Poor physical health Accidental or intentional assaults on
physical safety.
Chapter 4 12
Factors of Mental Health
POST TRAUMA AND CHILDHOOD SEXUAL ABUSE:
Childhood trauma predicts adult mental health.
Childhood sexual abuse is most common.
Problems range from depression and anxiety to the inability to socially function or partake in relationships.
Chapter 4 13
Factors of Mental Health
DOMESTIC VIOLENCE: A pattern of physical and sexual abuse,
psychological abuse with verbal intimidation and/or social isolation or deprivation.
More likely to involve females and children.
One of the foremost causes of serious injury to women ages 15-44.
Chapter 4 14
Interventions for Stressful Life Events
Family and friends Social support networks Religious and spiritual endeavors Complementary healers Physical activities Couple therapy Bereavement programs
Chapter 4 15
Anxiety Disorders
Most common and most frequently occurring mental disorders.
Types: Panic attacks and Panic disorder Agoraphobia Specific phobias Generalized Anxiety Disorders Obsessive-Compulsive Disorder Acute and Post-traumatic Disorders
Chapter 4 16
Anxiety Disorders
Panic attack is a period of intense fear or discomfort associated with numerous symptoms. Palpitations, sweating, trembling,
shortness of breath, sensations of choking or smothering, chest pain, nausea, gastrointestinal distress, dizziness or lightheadedness, tingling sensations and chills or blushing hot flashes.
Chapter 4 17
Panic Attacks and Panic Disorder
Onset is abrupt and climaxes within 10-15 min. and usually lasts no longer than 30min.
Distinguished from other anxiety by the onset being sudden and intensity.
Onset between late adolescence and mid-adult life, rare after 50.
Twice as common for women.
Chapter 4 18
Panic Attacks and Panic Disorder
Diagnosis: Must have at least four of the
symptoms previously stated. Must have had at least two
unexpected panic attacks and worry of having further ones.
Cannot be made for attacks caused by medication, or other medical disorders.
Chapter 4 19
Agoraphobia
Definition: severe anxiety about being in situations where escape is difficult.
Outcome of repeated panic attacks.
Twice as common in women.
Chapter 4 20
Specific Phobias
Common conditions are characterized by fear of specific objects or situations.
Most adults recognize fear as irrational, but typically avoid object or situation.
Approx. 8% suffer form one or more. Onset is in childhood with second peak
in mid 20’s. Don’t result from one single exposure. Runs in families (learned not genetic).
Chapter 4 21
Specific Phobias
Most common phobias: Fear of animals (snakes, rodents,
birds and dogs). Fear of insects (spiders, bees). Fear of heights, elevators, flying,
automobile driving, water, storms, blood and injections.
Chapter 4 22
Social Phobias (social anxiety disorder).
Describes people with persistent anxiety in social situations, including performances and public speaking.
Critical element of fear is possibility of embarrassment or ridicule.
Most adults recognize fear as being unreasonable, but dreaded events are avoided or tolerated with extreme discomfort.
Chapter 4 23
Generalized Anxiety Disorder
Defined as 6 months or more of anxiety and worry accompanied by multiple symptoms. Muscle tension, easily fatigued, poor
concentration, insomnia and irritability. Essential feature is anxiety and worry
cannot be attributed to distress associated with other conditions.
50% starts in adolescence and symptoms fluctuate with periods of stress .
Chapter 4 24
Obsessive-compulsive Disorder
Obsessions: recurrent, intrusive thoughts, impulses or images that are seen as inappropriate, grotesque or forbidden.
Common obsessions: Contamination with germs or body
fluids, order or symmetry, or loss of control of violent or sexual impulses.
Chapter 4 25
Obsessive-compulsive Disorder
Compulsions: behavior or mental acts that reduce anxiety which accompanies an obsession or prevents some dreaded even from happening.
Common compulsions: Hand washing, checking, and
mental acts like counting.
Chapter 4 26
Obsessive-compulsive Disorder
Equally common is women and men.
Begins in adolescence or young adulthood with fluctuating symptoms associated with stress.
Comorbid with major depression an other anxiety disorders.
Chapter 4 27
Acute & Post Traumatic Stress Disorders
Acute stress: anxiety and behavioral disturbances within 1st month after extreme trauma.
Dissociation of mind from body is a critical feature.
Usually have symptoms of generalized anxiety disorder.
Chapter 4 28
Acute and Post Traumatic Stress Disorders
Acute if: Less than three months Chronic: three or more months. Delayed onset: symptoms begin 6
months after trauma. Diagnosis of PTSD:
Acute stress persists more than one month and impairs normal functioning.
Chapter 4 29
Etiology of Anxiety Disorders
Evidence suggests a combination of life experiences, psychological traits and genetics are factors of developing anxiety disorders.
Acute Stress Response: Increased heart rate, blood
pressure, sweating, breathing and metabolism and tension of muscles.
Chapter 4 30
Etiology of Anxiety Disorders
New Views: Fear and anxiety are associated. Hippocampus and amygdala
(control of emotions) fear pathways are being destroyed to see if anxiety is still produced.
Chapter 4 31
Etiology of Anxiety Disorders
Neurotransmitters: Five deal with anxiety (serotonin,
GABA, norepinephrine, cholecystokinin and corticotropin-releasing hormone)
Changes in one affect all others Serotonin and GABA are inhibitory
neurotransmitters that quiet stress responses and are being used to treat anxiety.
Chapter 4 32
Etiology of Anxiety Disorders
Psychological Views of Anxiety Psychodynamic Behavioral Cognitive
Cognitive risk factor found in women.
Chapter 4 33
Treatment for Anxiety Disorders
Counseling and Psychotherapy Pharmacotherapy
Benzodiazepines Anti-Depressants Buspirone
A combination of both.