Mental disorder…

4P FACTOR MODEL_______________________________________________________________________________
Risk factor: Any characteristic/event that increases the likelihood of development/progression of a mental disorder
→ May be a biological, psychological or social factor
→ Can have a direct/indirect effect on mental wellbeing and typically combine effect
→ Risk factor for one person may not have the same effect or degree of influence on another person

Predisposing risk factor  Perpetuating risk factor 

Increases susceptibility to a MD
• Increase likelihood of the development of a disorder
• Doesn’t mean will inevitably develop disorder
Precipitating risk factor 
Increases susceptibility/contributes to occurrence of a
MD; present at the time of onset
• Immediate factors or events that have caused the
individual to experience symptoms ‘now’
• Commonly precede the onset of the disorder
• People may react differently to same event
Maintains occurrence of a MD and inhibits recovery
• Factors that are causing a person’s symptoms to
continue or progressively worsen
• Could be unresolved predisposing / precipitating
Protective factor 
Any characteristic or event that reduces or prevents
the occurrence or recurrence of a MD
• May be biological, psychological or social
• Lack of substance use would help prevent
occurrence of a substance use disorder

BIOLOGICAL RISK FACTORS_________________________________________________________________________

Biological risk factors either originate or develop within the body and consequently may not be under our control

Genetic vulnerability to a specific disorder Poor sleep

Having a risk for developing a MD due to one or more
factors associated with genetic inheritance
• Higher risk, doesn’t mean will definitely develop it
• Some genes are likely to contribute in subtle ways to
onset of MD under certain conditions
Poor sleep quantity or quality
• Include mood disorders, anxiety disorders, addictive
disorders, personality disorders, schizophrenia
• Difficulty falling/staying asleep, posttraumatic stress
disorder, acute stress disorder, anxiety/ depression

Poor response to medication due to genetic factors Substance use

Psychotropic-  medications designed to treat MHD
• May inhibit, alleviate, reduce symptoms (don’t cure)
• Poor response to med means having little/no
reduction in number/ severity of symptoms
• May be caused by genetics
Substance use  refers to the use or consumption of
legal or illegal drugs or other products (alcohol, drugs)
• Increase use increases risk of developing a MD
• Either person’s symptoms prompt substance use or
substance use is due to the mental disorder

PSYCHOLOGICAL RISK FACTORS_____________________________________________________________________

Psychological risk factors for mental disorders either originate or develop within the mind, which means there is often
the potential to exert some control over their occurrence or influence
Rumination
Involves repeatedly thinking about or dwelling on undesirable thoughts and feelings without acting to change them
• Often to the extent that a person cannot see a way of overcoming or minimising the impact
• If a situation is upsetting, likely person will remain upset for as long as they ruminate
• Rumination can increase the severity of depression and impede recovery

Impaired reasoning
REASONING: Goal-directed thinking in which inferences are made/conclusions are drawn from known/assumed info 
• Enables us to solve problems, thereby allowing us to deal with challenges we meet in everyday life

Probabilistic reasoning:  Making judgments related to probability (likelihood of something true happening)
Jumping to conclusions: Making hasty judgments or decisions on inadequate or ambiguous information

Impaired memory
• Both explicit/implicit LTM are impaired, episodic memories tend to show the greatest loss
• Episodic memory impairment also tends to be present before the presence of obvious psychotic symptoms
• Episodic memory impairment may experience difficulties recalling past events, times, places
• Cause disorganised behaviour and day-to-day functioning impairments

Stress
Stress-vulnerability model
Everyone has some level of vulnerability for MD and
risk varies in relation to combined effect, level of
stress experienced and ability to cope
• Depending on coping skills
• Higher level of vulnerability more likely develop MD
• Stress level may be influenced by a single or
combined stressor
Vulnerability
Predisposition that increases the likelihood of
developing a specific mental disorder
• Risk factors make it more likely that MD will emerge
• Protective factors safeguard against onset of a MD
and assist recovery and minimise relapse
• Interaction of risk/ protective factors influence
likelihood of symptoms occurring in vulnerable person

Poor self-efficacy
Individual’s belief in their capacity to execute behaviours necessary to succeed or accomplish a specific task
• Self-esteem is a judgment of self-worth, self-efficacy is a judgment of capability/ feeling of competence
• Poor SE impair ability to overcome challenges, dwell on inability to cope, magnify severity of possible worries
• When faced with difficulty easily give up, attribute failure to internal qualities , dwell on their personal deficiencies
• View bad performance as being due to lack of ability/ competence, doesn’t require much failure to lose faith

Bandura- social learning theory

• State of mind that varies from one specific task or Thought control efficacy
situation to another (good in cooking bad in sports) • How much control a person believes they have over
• Self-efficacy is a product of learning through their ruminative, negative and disturbing thoughts
experience (directly or indirectly- vicariously) • Not frequency of rumination that causes
anxiety/depression, but perceived inability ‘turn off’
SOCIAL FACTORS _________________________________________________________________________________
Social risk factors  for mental disorders originate in the external environment and interact with biological and
psychological factors in influencing our mental health state

Disorganised attachment
Type of attachment characterised by inconsistent or contradictory behaviour patterns with primary caregiver
• When reunited with a caregiver following separation, child expresses odd or ambivalent behaviour toward them
• Attachments formed during infancy influences socio-emotional development, in short term and into adulthood
• Disorganised attachment can result in anxiety and inner turmoil
• Children who have healthy attachment tend to be more skilled in reading and interpreting emotions in others
Children Adults
• Elevated levels of aggression • Difficult form close relationships (trusting)
• Disruptive/ impulsive behaviour • Seek out help/ social support
• Difficulty regulating their emotions • Difficulty managing stress

Loss of a significant relationship

Significant relationship: Relationship perceived by an individual as being of considerable importance to them
• Involve feelings of attachment, love, fulfilments, dependence, and the ability to have a meaningful influence
• Some people experiencing grief following loss of a significant relationship go on to develop depression

Grief: Natural/normal reaction to the experience of loss, comprising a mix of thought, feelings and behaviours
Prolonged grief: Grieving person remaining stuck in their negative state with unresolved grief

Role of stigma as a barrier to accessing treatment

Stigma: Mark or sign of shame, disgrace or disapproval typically associated with a particular characteristic
Stigmatise: Regard a person as unworthy or disgraceful (viewed in a negative way because of some characteristic)
Discrimination: When someone is actually treated in a negative way because of their mental disorder

Social stigma: Self-stigma:

Any aspect of an individual’s identity that is devalued
in a social context
• Involves negative attitudes, beliefs and behaviour in
community that motivate people to exclude, reject,
avoid, fear, discriminate against people with MD
★ Social stigmatising view about depression; ‘People
with depression should be able to snap out of it’
Stigmatising views that individuals hold about
themselves
• Occurs when individuals with a mental disorder
accept negative attitudes and beliefs held by others
and internalise or apply them to themselves
★ Self-stigmatising view by someone with depression;
‘I should be able to snap out of my depression’

Effects of stigma Discourages help-seeking

• Feelings of shame, self-doubt, poor self-esteem, low
self-efficacy, hopelessness and isolation
• Psychological distress
• Lack of understanding by family, friends or others
• Misrepresentation in the media
• Fewer social interaction/ employment opp
• Bullying, physical violence or harassment
• MHD is usually easier to treat if diagnosed early
• Many people with early symptoms are reluctant to
seek help because they associate MD with negative
and inaccurate beliefs, attitudes or stereotypes
• Because stigma can lead to a reluctance to seek
and/or accept necessary help, it is a barrier to
accessing treatment

CUMULATIVE RISK________________________________________________________________________________
Aggregate (cumulative) risk to mental health from combined effects of exposure to multiple risk factors
• Bio/psy/social factors rarely operate in isolation, often coexist/ interact with one another
• More risk factors to which we are exposed the greater our vulnerability to MHD
• Accumulation of risk factors increases likelihood of MHD, either through an additive or threshold effect

Additive models:
Propose that as the number of risk factors increases,
there is also a corresponding increase in the likelihood
of developing a mental disorder
• Relationship between risk factors and mental
disorder, tends to be linear
Multiplicative model:
Propose that risk of developing MD is more likely after
exposure to certain no. of concurrent (simultaneously)
risk factors and risk is total of separate effects
• Risk factors have multiplier effect as they
accumulate