1. Chapter 41 Surgeon General's Report: Chapter 4 : Adults and Mental Health By: Erica Bennett

2. Chapter 42 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.

3. Chapter 43 Factors of Mental Health PERSONALITY TRAITS: Self-Esteem  Self-Efficacy Neuroticism Avoidance Impulsivity Sociopathy

4. Chapter 44 Factors of Mental Health STRESSFUL LIFE EVENTS: Past trauma and child sexual abuse Domestic Violence Interventions for Stressful Life Events

5. Chapter 45 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

6. Chapter 46 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.

7. Chapter 47 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.

8. Chapter 48 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.

9. Chapter 49 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.

10. Chapter 410 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.

11. Chapter 411 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.

12. Chapter 412 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.

13. Chapter 413 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.

14. Chapter 414 Interventions for Stressful Life Events Family and friends Social support networks Religious and spiritual endeavors Complementary healers Physical activities Couple therapy Bereavement programs

15. Chapter 415 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

16. Chapter 416 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.

17. Chapter 417 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.

18. Chapter 418 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.

19. Chapter 419 Agoraphobia Definition: severe anxiety about being in situations where escape is difficult. Outcome of repeated panic attacks. Twice as common in women.

20. Chapter 420 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).

21. Chapter 421 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.

22. Chapter 422 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.

23. Chapter 423 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.

24. Chapter 424 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.

25. Chapter 425 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.

26. Chapter 426 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.

27. Chapter 427 Acute & Post Traumatic Stress Disorders Acute stress: anxiety and behavioral disturbances within 1 st month after extreme trauma. Dissociation of mind from body is a critical feature. Usually have symptoms of generalized anxiety disorder.

28. Chapter 428 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.

29. Chapter 429 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.

30. Chapter 430 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.

31. Chapter 431 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.

32. Chapter 432 Etiology of Anxiety Disorders Psychological Views of Anxiety  Psychodynamic  Behavioral  Cognitive  Cognitive risk factor found in women.

33. Chapter 433 Treatment for Anxiety Disorders Counseling and Psychotherapy Pharmacotherapy  Benzodiazepines  Anti-Depressants  Buspirone A combination of both.