KIN 1020 A-B

Thinking about Mental Health

Dr. Joel Goldberg
[email protected]
Chair,
Department of Psychology
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 Have you ever used a ‘poll the audience’ clicker?

1. No, never
2. Once or twice
3. Many times

3
 Why is York University Psychology major (BA ’10)
Lilly Singh famous?

1. Olympic beach
volleyball player
2. Rapper
3. City politician
4. Social activist

4
 Lilly Singh
York University Psych (BA ’10)

- Markham Ontario native

- YouTube video – IISuperwomanII led
to internet stardom
- Indo-Canadian comedian, actress and
rapper.
- Hits include:
- “Sh*t Brown People Say at Fam Jams”
- “Annoying People on Facebook”
- “When White People Listen to Indian
Music”
- “My Parents Reacting to Someone I’m
Dating,”
Agenda
Factors that contribute to mental illness – Bio-psycho-
social
Biological factors
Psychopharmacological treatments
Environmental, social and cultural factors
Psychological and personality vulnerability
Psychological treatments
Coping with Stress
 What factors contribute as causes of mental illness?
Bio-Psycho-Social Model

BIOLOGICAL
Genetic Vulnerability

MENTAL
HEALTH

SOCIAL-ENVIRONMENTAL PSYCHOLOGICAL
Cultural Factors Personality Vulnerability
Biological factors - Schizophrenia
Should people with schizophrenia be
considered to have a disability?
1. Yes
2. No
 Leading Causes of Disability
Ages 15 – 44 – WHO Global Burden of Disease in developed countries

Both Sexes Young Men Young Women

1. Major Depression 1. Alcohol Use 1. Major Depression

2. Alcohol Use 2. Road Traffic Accidents 2. Schizophrenia

3. Road Traffic Accidents 3. Major Depression 3. Road Traffic Accidents

4. Schizophrenia 4. Self-inflicted Injuries 4. Bipolar Disorder

5. Self-inflicted Injuries 5. Schizophrenia 5. Obsessive-Compulsive Disorder

6. Bipolar Disorder 6. Drug Use 6. Alcohol Use

7. Drug Use 7. Violence 7. Osteoarthritis

Murray and Lopez, 1996; World Health organization

(WHO)
Drug Treatments for Schizophrenia
First generation anti-psychotic drugs (1950s)
Helped people to not have to stay in hospital due to
psychosis
For some however, first generation medicines (e.g.,
haldol or chloropromazine) did not work or had
terrible side-effects like tardive dyskinesia (movement
disorder)
Introduced second generation anti-psychotic
medications
(e.g., clozapine) (1990s)
Problem: clozapine – agranulocytosis side-effect in 1%
of cases, suppress the immune system, could cause
Should Clozapine be used for the treatment
of schizophrenia?
1. No, because it could
cause death
2. Yes, but inform
people of the small
risk of death
3. Maybe, but we need
to figure out how to
reduce the risks
The Paranoid Runner

? The Paranoid Runner - YouTube.mp4

Environmental – Cultural Influences

• Television was first introduced onto the

Pacific island of Fiji in the mid-1990s

• Researchers monitored the effects of

television over a three year period on mental
health
(Becker, 2002; British Journal of Psychiatry)
What serious mental health disorder began
after television was first introduced into this
island culture?

1. Depression
2. Anxiety
3. Eating Disorders
4. Schizophrenia
Effects of Culture on Expectations for Thin
Body Image

? Beauty Pressure - YouTube.mp4

Current Picture – eating issues
 70% of women are on a diet

 80-90% of women dislike the shape or size of their bodies

 Some young girls report being more afraid of becoming fat

than they are of cancer, nuclear war, or losing their parents

 A number of young people who have eating disorders use

excessive exercise in order to control their weight and as a
way of regulating negative emotional states

? Sonia and Julia Intervention - part 1-5 - YouTube.mp4

Psychological – Personality
Case Study
32 year old was injured in a car accident, diagnosed
with whiplash strain injuries, pain in neck and low
back
Functional Assessment by Kinesiologist showed
reduced range of motion, referral to physiotherapy; she
refused to attend due to driving fears
What is her psychological diagnosis?
1. No diagnosis. She just
doesn’t want to go to
physio
2. No diagnosis. She is
faking symptoms to get
money from the
insurance company
3. Possible post-traumatic
stress disorder. Need to
evaluate her fears
4. Possible depression.
Case Study – Interview
Established rapport
Careful observation – noticed that she was self-
protective about her bodily movements, fearing re-injury
Described the accident, happened at dusk: stopped in a
line of traffic which was not moving even though the
light had changed
Image of truck’s headlights in rear-view mirror, sound of
crash was described as like an explosion
Asked later if anything else that she forgot to tell, she
began crying, revealed that she saw a pedestrian crossing
the street and feared for the person’s life
Case Study (cont.)
Personal history revealed she was raised in war-torn country,
the sixth of ten children – father successful businessman
She completed college nursing program.
Tragedy struck when gun-toting rebels killed father and
three older brothers
Mother and surviving children fled to country home on city
outskirts
That night, slept in central outdoor courtyard of home
because of summer heat.
Rocket-launcher struck side of home, fiery explosion etched
in her memory. Managed to escape and fled to refugee camp
Case Study (cont.)
Symptom review:
Phobic avoidance of driving
Nightmares
Startle reactions
Blocked recall of certain aspects of the event
Case study (cont.)
Treatment:
Individual psychotherapy with counselor familiar with
trauma counseling
Behavioural intervention of driving fears, gradual
‘exposure’ with in-car driving therapist
Sources of Stress
Life Events (Holmes & Rahe, 1967) – Social
Readjustment rating Scale.
Examined major life events
Arbitrarily set the middle – 50 – as marriage
Highest stress – Death of a spouse
Correlated with illness
Daily Hassles (Lazarus & Folkman, 1984)
Daily events – minor irritations that affect us every day
The most upsetting daily hassle for me as a
student is
1. Tests, exams and
quizzes
2. Relationship problems
with my friend(s)
3. Relationship problems
with my family
4. Money problems
5. Getting to school
6. Managing both work
and school demands
Cognitive Appraisals
Dr. Richard Lazarus, University of California

• Looking at the situation - stress (-) or challenge

(+)
• Glass – half-empty or half-full
• It’s all in the way you look at it…..
Date Situation Emotion(s) Automatic Rational Outcome
Describe: Thought(s) Response
1. Actual event leading 1. Specify sad/ 1. Write automatic 1. Write rational 1. Re-rate belief in
to unpleasant anxious/angry, thought(s) that preceded response to automatic automatic
emotion etc. emotion(s) thought(s) thought(s) 0-
2. Stream of thoughts, 2. Rate degree of 2. Rate belief in automatic 100%
2. Rate belief in rational
daydream, or emotion thought(s), 0-100%. repsonse 0-100% 2. Specify & rate
recollection, leading 1-100 subsequent
to unpleasant emotions 0-100.
emotion
Date Situation Emotion(s) Automatic Rational Outcome
Describe: Thought(s) Response
1. Actual event 1. Specify sad/ 1. Write automatic 1. Write rational 1. Re-rate belief in
leading to anxious/angry, thought(s) that preceded response to automatic automatic
unpleasant emotion etc. emotion(s) thought(s) thought(s) 0-
2. Stream of thoughts, 2. Rate degree of 2. Rate belief in automatic 100%
2. Rate belief in rational
daydream, or emotion thought(s), 0-100%. repsonse 0-100% 2. Specify & rate
recollection, 1-100 subsequent
leading to emotions 0-100.
unpleasant emotion

“I have done well on

9/12 Low marks on Sad/Anxious “I did poorly on the other tests in the 40%
test 90 test because I am a past, after all, I did Sad/Anxious
loser as a person” make it into
60
90% university.”

“When the going

gets tough, the
tough get going.”
“Maybe I will review
my study notes
better next time.”

“Just because I did

poorly on the test
doesn’t mean I am a
failure as a person.”
80%
My score on the stress checklist is:
(I understand that I do not have to answer this poll)

1. Less than 5
2. Between 5 – 10
3. Between 11 – 15
4. Higher than 15
 Prevalence of Drug Use in Past Year
Ontario Grades 7, 9, 11 (1977 - 2011)

80
70
60
% of Students

50 Alcohol
Cigarettes
40
Any Ilicit
30
20
10
0

CAMH: Drug Use Among Ontario Students, 1977-2011 (2011) N: 2013 - 4669
 Low-Risk Alcohol Drinking Guidelines
Centre for Addiction and Mental Health
Association of Local Public Health Agencies
Ontario Public Health Association

Drink no more than 2 standard drinks on any day

Limit weekly intake to:
 less than or equal to 14 drinks for men
 less than or equal to 9 for women
Coping
Stress Checklist
Relaxation – Mindfulness – Meditation
What we can learn from an ‘outlier’ community
Roseto Pennsylvania – What we can learn from an
outlier community…
Malcolm Gladwell – Outliers (2008)

Dr. Stewart Wolfe – University of Oklahoma sociology

study

Phenomenon:
No one under age 55 had died of heart attack
For men over 65, death rate was half of national
average
No suicide, no alcoholism, no drug addiction, very
little crime
Why were the people who live in this
isolated town in Pennsylvania so
healthy?

1. Diet and exercise

2. Genetics
3. Geographic location
4. Other factor
Why are people who live in Roseto so
healthy – both physically and mentally?
Dietary factors – no!
Genetics – no!
Geography – no!
Sense of Community – Social Support
Three generations living under one roof
Regular church attendance
22 civic organizations (for a town of just 2000 people)
Reduced competitiveness – wealthy did not flaunt success
Women work in blouse factory, men in slate quarries, go
to work together, after work, sit on porches
Coping
Stress Checklist
Relaxation
Support
Overcoming stigma

? Change A Mind About Mental Illness - YouTube.mp4

Jim Abbott