MENTAL HEALTH STUDY GUIDE LATEST UPDATED EDITION 2024/2025
What does it mean to be mentally healthy? Erikson (1963) has suggested that the mentally healthy older
person possesses a sense of ego integrity and self-acceptance that will help in adapting to the ambiguities
of the future with a sense of security and optimism.
mental health is “the successful adaptation to stressors from the internal or external environment,
evidenced by thoughts, feelings, and behaviors that are age-appropriate and congruent with local and
cultural norms.”
Mental illness- Hippocrates was the first to place mental illness in a physical rather than supernatural
context. Hippocrates theorize that mental illness was caused by irregularity in the interaction of the four
body fluids: blood, black bile, yellow bile, and phlegm. He called these body fluids humors and
associated each with a particular disposition. Disequilibrium among these four humors was often treated
by inducing vomiting and diarrhea with potent cathartic drugs.
Benjamin Rush, often called the father of American psychiatry, was a physician at the hospital. He
initiated the provision of humanistic treatment and care for clients with mental illness
,MENTAL HEALTH STUDY GUIDE LATEST UPDATED EDITION 2024/2025
TABLE 2–1 Levels of Anxiety
EMOTIONAL AND
ABILITY TO BEHAVIORAL
LEVEL PERCEPTUAL FIELD LEARN CHARACTERISTICS CHARACTERISTICS
Mild Heightened perception Learning is Restlessness May remain superficial with
(e.g., noises may enhanced Irritability others
seem louder; details Rarely experienced as
within the distressful
environment are Motivation is increased
clearer)
Increased awareness
Increased alertness
Moderate Reduction in perceptual Learning still Increased A feeling of discontent
field occurs but not restlessness May lead to a degree of
Reduced alertness to at optimal Increased heart and impairment in interpersonal
environmental events ability respiration rates relationships as individual
(e.g., someone Decreased Increased perspiration begins to focus on self and
talking may not be attention span Gastric discomfort the need to relieve personal
heard; part of the Decreased Increased muscular discomfort
room may not be ability to tension
noticed) concentrate Increase in speech
rate, volume, and
pitch
Severe Greatly diminished; only Extremely limited Headaches Feelings of dread, loathing,
extraneous details attention span Dizziness horror
are perceived, or Unable to Nausea Total focus on self and intense
fixation on a single concentrate or Trembling desire to relieve the anxiety
detail may occur problem-solve Insomnia
May not take notice of Effective Palpitations
an event even when learning Tachycardia
attention is directed cannot occur Hyperventilation
by another Urinary frequency
Diarrhea
Panic Unable to focus on Learning cannot Dilated pupils Sense of impending doom
even one detail within occur Labored breathing Terror
the environment Unable to Severe trembling Bizarre behavior, including
Misperceptions of the concentrate Sleeplessness shouting, screaming,
environment common Unable to Palpitations running about wildly,
(e.g., a perceived comprehend Diaphoresis and pallor clinging to anyone or
detail may be even simple Muscular anything from which a
elaborated and out of directions incoordination sense of safety and security
proportion) Immobility or is derived
purposeless Hallucinations, delusions
hyperactivity Extreme withdrawal into self
Incoherence or
inability to verbalize
,MENTAL HEALTH STUDY GUIDE LATEST UPDATED EDITION 2024/2025
The following disorders are examples of psychoneurotic responses to anxiety as they appear in the DSM-
5:
• ■ Anxiety disorders: Disorders in which the characteristic features are symptoms of
anxiety and avoidance behavior (e.g., phobias, panic disorder, generalized anxiety disorder, and
separation anxiety disorder).
• ■ Somatic symptom disorders: Disorders in which the characteristic features are
physical symptoms for which there is no evident organic pathology. Psychological factors are
judged to play a significant role in the onset, severity, exacerbation, or maintenance of the
symptoms (e.g., somatic symptom disorder, illness anxiety disorder, conversion disorder, and
factitious disorder).
• ■ Dissociative disorders: Disorders in which the characteristic feature is a disruption in
the usually integrated functions of consciousness, memory, identity, or perception of the
environment (e.g., dissociative amnesia, dissociative identity disorder, and depersonalization-
derealization disorder).
Menninger (1963) described the following types of coping mechanisms that individuals use to
relieve anxiety in stressful situations:
• Sleeping
• Yawning
• Eating
• Drinking
• Physical exercise
• Daydreaming
• Smoking
• Laughing
• Crying
• Cursing
• Pacing
• Nail biting
• Foot swinging
• Finger tapping
• Fidgeting
• Talking to someone with whom one feels comfortable
TABLE 2–2 Ego Defense Mechanisms
DEFENSE MECHANISM EXAMPLE
COMPENSATION
Covering up a real or perceived weakness by A physically disabled boy is unable to participate in
emphasizing a trait one considers more desirable football, so he compensates by becoming a great
scholar.
RATIONALIZATION
, MENTAL HEALTH STUDY GUIDE LATEST UPDATED EDITION 2024/2025
Attempting to make excuses or formulate logical A patient tells the rehab nurse, “I drink because it’s the
reasons to justify unacceptable feelings or only way I can deal with my bad marriage and my worse
behaviors job.”
DENIAL
Refusing to acknowledge the existence of a real A woman drinks alcohol every day and cannot stop,
situation or the feelings associated with it failing to acknowledge that she has a problem.
REACTION FORMATION
Preventing unacceptable or undesirable thoughts A student hates nursing and only attended nursing
or behaviors from being expressed by school to please her parents. During career day, she
exaggerating opposite thoughts or types of speaks to prospective students about the excellence of
behaviors nursing as a career.
DISPLACEMENT
The transfer of feelings from one target to another A patient is angry with his physician, does not express it,
that is considered less threatening or that is but becomes verbally abusive with the nurse.
neutral
REGRESSION
Retreating in response to stress to an earlier level When a 2-year-old is hospitalized for tonsillitis, he will
of development and the comfort measures drink only from a bottle, even though his mother states
associated with that level of functioning he has been drinking from a cup for 6 months.
IDENTIFICATION
An attempt to increase self-worth by acquiring A teenager who required lengthy rehabilitation after an
certain attributes and characteristics of an accident decides to become a physical therapist as a
individual one admires result of his experiences.
REPRESSION
Involuntarily blocking unpleasant feelings and A trauma victim is unable to remember anything about
experiences from one’s awareness the traumatic event.
INTELLECTUALIZATION
An attempt to avoid expressing actual emotions A woman’s husband is being transferred with his job to a
associated with a stressful situation by using the city far away from her parents. She hides anxiety by
intellectual processes of logic, reasoning, and explaining to her parents the advantages associated with
analysis the move.
SUBLIMATION
Rechanneling of drives or impulses that are A mother whose son was killed by a drunk driver
personally or socially unacceptable into activities channels her anger and energy into being the president
that are constructive of the local chapter of Mothers Against Drunk Driving.
INTROJECTION
Integrating the beliefs and values of another Children integrate their parents’ value system into the
individual into one’s own ego structure process of conscience formation. A child says to a friend,
“Don’t cheat. It’s wrong.”
SUPPRESSION
The voluntary blocking of unpleasant feelings and “I don’t want to think about that now. I’ll think about that
experiences from one’s awareness tomorrow.”
ISOLATION
Separating a thought or memory from the feeling, A young woman describes being attacked and raped