prelim review psych

• Three levels of care in the Health Care System in the Philippines:

  • Primary care: first point of contact for outpatient medical care
  • Secondary care: includes referrals to psychologists and psychiatrists for short hospital visits and consultation-liaison services
  • Tertiary care: includes referrals to psychiatric institutions for specialized care and severe mental illness rehabilitation
• National Center for Mental Health (NCMH) in the Philippines:

  • Established in 1925 under the Public Works Act 3258
• Philippine Mental Health Association, Inc.:

  • Established in 1950 to address mental health problems induced by WW II
  • Provides psychiatric, psychological, and counseling services to all sectors of society under CDS
  • Has two centers: Center for Children and Youth (CCY) and Adult Work Center (AWC)
• Major hospitals in the National Capital Region of the Philippines with psychiatric departments include:

  • The Medical City
  • Philippine General Hospital (PGH)
  • Manila Doctors Hospital (MDH)
  • University of the East Ramon Magsaysay Memorial Medical Center (UERMMMC)
• Suicide Prevention Hotlines in the Philippines:

  • Natasha Goulbourn Foundation (NGF): (02) 804-HOPE (4673), 0917 558 HOPE (4673), or 2919 (toll-free for GLOBE and TM subscribers)
  • Manila Lifeline Centre (MLC): [phone] or 0917 854 9191
• Mental Health Act (Republic Act No. 11036) in the Philippines aims to enhance mental health services, promote mental health, provide accessible mental health care, and protect the rights of individuals utilizing psychiatric, neurologic, and psychosocial health services
• Mental Health Gap Action Programmed (mhGAP) Training:

  • WHO program launched in 2008 to scale up care for mental, neurological, and substance abuse disorders
• Anxiety is a vague unpleasant feeling of apprehension, an emotional response to unknown and non-specific danger or threat
• Normal anxiety is considered appropriate to the situation, while abnormal anxiety is excessive, chronic, and results in impairment in the individual’s major functioning
• Types of anxiety:

  • Mild anxiety: perception increases, behavioral changes include being alert/aware, energetic, and having increased attention; physiological changes involve slight discomfort, restlessness, and coping is adaptive
• • Moderate anxiety: perception decreases, behavioral changes include difficulty in concentration, physiological changes like clammy hands and muscle tension, coping is palliative
• • Panic anxiety: perception is disorganized, behavioral changes include feeling overwhelmed and out of control, physiological changes are similar to severe anxiety, coping is dysfunctional
• Adaptation is the physical or behavioral characteristic of an organism that helps it survive better in the surrounding environment
• Coping involves any effort to decrease the stress response and can be constructive or destructive
• Defense mechanisms are patterns of behavior or thinking used to protect oneself from threatening aspects of the environment or from feelings of anxiety
• Types of defense mechanisms:

  • Normal and adaptive mechanisms like anticipation and sublimation
  • Narcissistic mechanisms like denial and projection
  • Immature mechanisms like conversion and regression
• Underlying causes of anxiety:

  • Interpersonal factors like fear of rejection
  • Behavioral factors like exposure to early negative life circumstances
  • Psychoanalytic factors like conflict between the ID and the Superego
• Crisis occurs when the event causing anxiety is overwhelming and usual coping patterns are suspended, types include maturational, situational, and adventitious
• Stages of crisis:

  • Denial
  • Increased tension
  • Disorganization
  • Attempts to reorganize
• Mental health is defined by fulfilling roles in society and appropriate behavior, while mental illness is characterized by failure to fulfill roles and carry out responsibilities or inappropriate behavior
• Mental health, defined by the WHO, is a state of well-being where individuals realize their potential, cope with life stresses, work productively, contribute to the community, and meet criteria like positive self-attitude, reality perception, autonomous behavior, integrative capacity, self-actualization, personal growth, and environmental mastery
• Mental illness is a health condition marked by alterations in thinking, mood, or behavior that cause distress and impair major functioning areas like occupational, social, emotional, psychological, and spiritual functioning
• Factors contributing to mental illness include biologic factors (genetic, neurostructural, brain defects or injury, prenatal damage, brain chemistry), individual factors (PAIN: poor physical health, any kind of loss, ineffective coping, negative view of self), interpersonal factors (FAIL: faulty family interaction, absence of sense of belongingness, ineffective communication, loss of emotional control), and environmental factors (PAIN: poverty, abuse, inability to use support resources, negative view of the world)
• Risk factors for mental illness include a history of mental illness in a blood relative, stressful life situations, ongoing medical conditions, brain damage, traumatic experiences, substance use, childhood history of abuse or neglect, few healthy relationships, and previous mental illness
• Complications of mental illness can lead to severe emotional, behavioral, and physical health problems, including unhappiness, family conflicts, social isolation, substance abuse, missed work or school, legal and financial problems, self-harm, weakened immune system, heart disease, and other medical conditions
• The DSM-5 classifies mental disorders into categories like bipolar and related disorders, depressive disorders, schizophrenia spectrum and other psychotic disorders, anxiety disorders, obsessive-compulsive and related disorders, trauma and stressor-related disorders, dissociative disorders, somatic symptom and related disorders, personality disorders, eating and feeding disorders, elimination disorders, sleep-wake disorders, sexual dysfunctions, paraphilic disorders, gender dysphoria, neurocognitive disorders, neurodevelopmental disorders, substance-related and addictive disorders, disruptive, impulse-control, and conduct disorders, and other mental disorders
• Signs of mental health include finding life enjoyable, seeing responsibilities for meeting needs in objects, people, and activities, having control over behavior by recognizing and acting on cues to existing limits, and responding to rules and routines
• Signs of Mental Health:

  • Happiness: finds life enjoyable and can see in objects, people, and activities their responsibilities for meeting needs
  • Control over behavior: can recognize and act on cues to existing limits and respond to the rules, routines, and customs of any group
  • Appraisal of reality: accurate picture of surroundings and good sense of consequences of actions
  • Effectiveness in work: within limits set by abilities, can do well in tasks attempted and persist when facing mild failure
  • A healthy self-concept: sees self as capable and has a reasonable degree of self-confidence
  • Satisfying relationships: experiences satisfaction and stability, socially integrated and relies on social supports
  • Effective coping strategies: uses stress reduction strategies that address the problem issue in a healthy way
• Signs of Mental Illness:

  • Major Depressive Episode: loss of interest in activities, describes mood as depressed
  • Impulse control disorder & aggressive behavior: shows repetitive and persistent pattern of aggressive conduct violating others' rights
  • Schizophrenia & psychotic disorders: shows bizarre delusions, auditory hallucinations, and manifests delusions with persecutory or jealous content
  • Adjustment disorder with work (or Academic) Inhibition: shows inhibition in work or academic functioning compared to previous performance
  • Dependent personality disorder: passively allows others to assume responsibility due to inability to function independently, lacks self-confidence
  • Borderline personality disorder: shows unstable and intense interpersonal relationships, chronic feeling of emptiness
  • Substance dependence: repeatedly self-administers substances despite significant problems
• Coping Mechanisms:

  • Involves any effort to decrease the stress response, can be constructive (task-oriented or defense-oriented) or destructive
• Defense Mechanisms:

  • Used to protect self from threatening aspects of the environment and from own feelings of anxiety
  • Types include compensation, compromise, identification, sublimation, substitution, conversion, denial, displacement, dissociation, fantasy, fixation, intellectualization, introjection, isolation, projection, rationalization, reaction formation, regression, repression, suppression, symbolism, undoing
• Psychoanalytic Models:

  • Sigmund Freud: founder of psychoanalysis, developed personality theory and theory of infantile sexuality
  • Anna Freud: applied ego psychology to psychoanalytic treatment and child analysis, emphasized adaptive functions of defense mechanisms
• Neo-Freudian Models:

  • Alfred Adler: founded individual psychology, major concept of inferiority
  • Carl Gustav Jung: redefined libido, introversion, extroversion, persona
  • Otto Rank: introduced primary trauma of birth, emphasized feelings in analytic process
  • Erich Fromm: emphasized relationship of individual to society, concept that individual and society are not separate
• Interpersonal Relation Models:

  • Harry Stack Sullivan: impulses and striving need to be understood in terms of interpersonal situations
  • Major concepts include participant observer, parataxic distortion, consensual validation
• Humanist Theories:

  • Abraham Maslow: focused on healthy individuals, needs motivation
  • Frederick S. Perl's: awareness of emotion and repressed needs to deal with emotional problems, major concepts of reality and here and now
  • Carl Rogers: based theory on human potential for goodness, stressed therapist-client relationship, major concepts of empathy and positive regard
• Carl Rogers (1902-1987) based his theory on the view of human potential for goodness and used the term 'client' instead of 'patient'
• Rogers stressed the importance of the relationship between therapist and client
• Major concepts in Rogers' theory include empathy and positive regard
• Rogers' individual therapy approach involves never giving advice and always clarifying the client’s feelings
• Sigmund Freud's psychodynamic theory includes personality components:

  • Id: functions in the unconscious level of awareness and concerns with pleasure principles
  • Ego: functions primarily on the conscious level of awareness and concerns with reality principles
  • Superego: functions primarily on the subconscious level of awareness and in moral principles, consisting of conscience and ego ideal