PSYCH WEEK 3
PERSONALITY THEORIES AND
DETERMINANTS OF PSYCHOPATHOLOGY AS
MODELS OF CARE
PERSONALITY
- Distinctive and enduring characteristic
patterns of thinking, feeling and behaving
- Studied by trying to understand differences
in specific characteristics; ;ooking at how all
the various parts of each person mesh
together as a whole
Nine perspectives on personality theories:
1. Psychobiologic
2. Cognitive
3. Psychosocial
4. Behavioral
5. Interpersonal
6. Humanistic
7. Psycho-spiritual
8. Eclectic
9. Psychodynamic/Psychoanalytic
PSYCHOBIOLOGICAL THEORY
- As a field of study, is focused on the science of
the brain’s anatomy and physiology
- Influenced by biochemical alteration, genetics,
mental illness as biophysical impairment
- Thoughts, sensations, joys, and aches are
activities of the 100 billion neurons in brain
tissues, Neuroscientists can almost read people’s
thoughts from the blood flow of their brains as
well as if the person is thinking of a place/face or
looking at a bottle/shoe
- Meds are utilized to correct biochemical
imbalances in the brain
COGNITIVE THEORY
- Within the premises of cognitive theory that
thoughts, ideas and beliefs affects feelings
and behaviors
- Focuses on how a person’s thinking about a
situation or event affects the stimulus and
response
- Addresses a person’s thinking about an
event or situation as having an effect on his
or her response to a stimulus (behavior)
PSYCHOSOCIAL THEORY
- Understanding the influences of and
interaction between the environment,
cognition, and a person’s behavior
- People influence are and are influenced by
their environment, and that a reciprocal
relationship between an individual and their
social environment exists. Environment
affects behavior. (Erik Erikson's stages of
development)
BEHAVIORAL THEORY
- Behavior is learned. The person becomes
who they are by environmental shaping;
behavior can be observed, described,
recorded, subject to reward and punishment
- Proposes that a person’s behavior is the
result of learning that is a response to a
stimulus
- A person may learn a certain response
(behavior) either to receive a reward or to
avoid a punishment
PSYCHODYNAMIC/PSYCHOANALYTIC
THEORY
- It is a psychological model in which
behavior is explained in terms of past
experiences and motivational forces; actions
are viewed as stemming from inherited
instincts, biological drives, and attempts to
resolve conflicts between personal needs
and social requirements
- Freud believed that our personality is largely
shaped by our enduring conflict between our
impulses to do whatever we feel like, and
out restraint to control these urges between
pleasure-seeking urges and our inner social
control over them. Actions are believed to
be motivated by emotions and thoughts
- Temper Tantrums - ignore
-
Freud believed that anxiety comes from the
part of the ego getting all stressed out about
losing control over the id and superego so he
proposed that our ego used a series of
defense mechanisms as a method of
reducing anxiety
- Castration Complex -
Ego - mostly conscious; make peace between the id
and the superego (Personality principle)
Id - Unconscious energy (Pleasure Principle)
Superego - Internalized ideas (Morality Principle)
Preconscious: anything that potentially brought to
conscious even if you forgot; storehouse of
memories______; Psychoanalysis, sleep
within each individual regardless of belief
system and serves as a force for
interconnectedness between the self and
others, the environment, and a higher power
- The earliest practices- focused on spiritual
treatment (insanity was considered a
disruption of mind and spirit.
- Reeves and Reynolds - a large volume of
contemporary research (>60 studies)
demonstrating the value of spirituality for
both medical and psychiatric pts is
influencing this change.
*Religious articles, bibles are not allowed in the
ward due to risk of enhancement of religious
preoccupation.
INTERPERSONAL THEORY
- Unsatisfactory interpersonal relations
primarily cause maladaptive behavior
- Sullivan believed that poor relationships
cause anxiety - basis for all emotional
problems
- Hildegard Peplau (mother of psychiatric
nursing) considers nursing to be an
interpersonal process between nurse and
client (nurse-client therapeutic relationship)
ECLECTIC THEORY
- Selects combines and incorporates the
diverse techniques from several theories
- Utilizes more than one personality theories
and determinants of psychopathology as
models of care and joins those models into
an integrated approach increasing the
parameters involved.
*Simultaneous use of different therapeutic
approaches: meds, psychoanalysis, physical, etc.
HUMANISTIC THEORY
- Focuses on the present and the “here &
now” with nothing to do with the past.
- It moved traditional concepts of mental
health and illness from a focus on illness,
determinism, the unconscious, and
reductionism to a focus on health.
- Humanistic theories reflected the theoretical
shift towards a more holistic, interpersonal,
positive perspective.
E.g. the pt says “I am an alcoholic and I need help
from the psych team.” Don’t consider the past
(humanistic theory) unless the pt’s father and
grandfather are alcoholics (Psychobiological theorygenetics), or the pt has not ascended the “oral stage”
of development (psychoanalytic/psychodynamic
theory - freud)
mhGAP
- Depression- leading causes of disability
- Suicide - 2nd leading cause of death (15-29
years old)
- People with severe mental health conditions
die prematurely-due to preventable physical
condtions
- 1 psychiatrists for every 100,000 people;
Fewer neurologists
- mhGAP used to scale ups services,
allocation of financial and human resources
of care for mental neurological and
substance use disorders for countries esp in
low-income countries.
- Obj. to achieve much higher coverage with
key interventions in the countries with low
and lower-middle incomes that have a large
proportion of the global burden of MNS
disorders
Development of the mhGAP Intervention Guide
(mhGAP-IG)
PSYCHO-SPIRITUAL THEORY
- Spirituality is the human quality that gives
meaning and sense of purpose to an
individual’s existence. Spirituality exists
-
-
-
Resource to facilitate delivery of the
mhGAP evidence-based guidelines in nonspecialized health care settings
Grounded on the best available scientific
and epidemiological evidence on priority
conditions
Demonstrated the feasibility of delivery of
pharmacological and psychosocial
interventions in non-specialized healthcare
settings
PRIORITY CONDITIONS
● Depression (DEP) pink
● Psychoses (PSY)
● Epilepsy(EPI)
● Child and Adolescent Mental and
Behavioral Disorders (CMH)
● Dementia (DEM)
● Disorders due to Substance use (SUB)
● Suicide
Masterchart - guides the clinician on the priorities
Parts: Essential Care & Practice; Master Chart;
Module (Assessment, Management, Followup
PFA/mhGAP - Anyone can learn (Priority are the
hospital care team to the grassroots)
Crisis Intervention/Critical Incidence Stress
Debriefer - Nurses and Psychologists
Important: to describe thru assessment the status of
the
FRAMEWORK FOR COUNTRY ACTION
- Political commitment (main foundation)
- Establish a core group of stakeholders with
expertise for guidance
- Acquisition of the necessary human and financial
resources
ASSESSMENT OF NEEDS AND RESOURCES
- Describe the status of the burden of MNS
disorders
- Identify human, financial and material resources
- Examine the coverahe and quality of essential
interventions, and any reasons for low or
ineffective coverage
- Describe any current policies that are relevant to
MNS disorders
- Synthesize the information to highlight important
gaps that must be addressed for scaling up care for
MNS disorders
DEVELOPMENT OF A POLICY
- Draft or revise policy to set out its vision, values,
and principles, its objectives, and key areas for
action;
- Incorporate existing knowledge about the
improvement of treatment and care and prevention
of MNS disorders
- Involve all relevant stakeholders
- Work with other relevant sectors, and review other
relevant policies; and
- Develop means for implementation of the policy
DELIVERY OF INTERVENTION PACKAGE
- The decision about how best to deliver the chosen
interventions at health facility, community, and
household levels are critical to ensure maximum,
high quality and equitable coverage of the
interventions (on non-specialized hospitals only)
STRENGTHENING OF HUMAN RESOURCES
- Appropriate pers-service and in-service training of
different cadres of health professionals with
curricula that are needs-based and fit-for-purpose
- Improvement of access to information and
knowledge resources
- Development of supportive supervision
- Development of simplified diagnostic and
treatment tools
MOBILIZATION OF FINANCIAL RESOURCES
- Accurate costing
- Probable need to increase the budget
- External funding could be used
MONITORING AND EVALUATION
- The indicators for measurement can be programe
inputs and activities, outputs, outcomes and
impact/health status
BUILDING PARTNERSHIPS
- UN agencies (UNICEF)
- Government ministries
- Donors
- NGOs and WHO collaborating centers
- Civil society