Chapter 1 Lesson 2

Instructional Module in NCM 117a (Care of Clients with Maladaptive Patterns of Behavior, Acute and
Chronic) |1
CHAPTER I. CONCEPTS OF MENTAL HEALTH AND MENTAL ILLNESS
LESSON 2: PSYCHOBIOLOGIC BASES OF BEHAVIOR
INTRODUCTION OF THE LESSON

AND PRESENTATION OF OUTCOMES
This lesson focuses on the psychobiological processes that play a role in how we
think, feel, react and behave.
Psychobiology is a branch of psychology that analyzes how the brain,

neurotransmitters, and other aspects of our biology influence our behaviors, thoughts, and
feelings. This field of psychology is often referred to by a variety of names including
biopsychology, physiological psychology, behavioral neuroscience, and biopsychology.
Although much remains unknown about what causes mental illness, science in the
past three decades has made great strides in helping us understand how the brain works
and in presenting possible causes of why some brains work differently from others. Such
advances in neurobiologic research are continually expanding the knowledge base in the
field of psychiatry and are greatly influencing clinical practice.
LEARNING OUTCOMES FOR THIS LESSON
At the end of this lesson, you must have:
1. Described neurons as to components, functions, and types;

2. Discussed how alterations in the structures and functions of the central nervous
system affect human behavior;
3. Differentiated memory and learning;
4. Discussed the process of neurotransmission;
5. Enumerated the major neurotransmitters with their corresponding location,
functions;
6. Discussed possible implications of the different neurotransmitters to mental illness;
7. Related family dynamics to mental health and mental illness;
8. Described the different patterns of behavior;
9. Discussed the concepts of human behavior;
10. Differentiated mental health and mental illness;
11. Discussed how needs affect human behavior;
12. Discussed the relationship between needs and frustrations;
13. Differentiated frustration and conflict;
14. Discussed the causes of, and responses to frustrations;
15. Presented sample situations for each of the different types of conflict;
16. Differentiated the levels of anxiety as to physiological and psychological responses;
17. Discussed the patterns of adaptation; and
18. Discussed crisis as to its characteristics, phases, and classes.
Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

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WARM-UP ACTIVITY. Based on your previous knowledge, how

would you respond to client or family questions about the cause of
the client’s abnormal behavior? How will explain this information
in a meaningful way?
CENTRAL ACTIVITIES
This part of the lesson includes two learning inputs and two activities. You need to
accomplish the activities and submit them in the designated folders of this lesson.
LEARNING INPUT 1.
Neuro-anatomy and Neurophysiology
In order for you to become an efficient psychiatric–mental health nurse, you must
have a basic understanding of how the brain functions. Three of the most important
components to understand are the neurons; the central nervous system; and the concepts
of memory, repetition and learning neurotransmitters.
Neurons
A neuron is a nerve cell that is the basic building block of the nervous system.
Neurons are similar to other cells in the human body in a number of ways, but there is one
key difference between neurons and other cells. Neurons are specialized to transmit
information throughout the body. These highly specialized nerve cells are responsible for
communicating information in both chemical and electrical forms.
Figure 1.1 shows the basic components of a neuron. These include the soma
(cell body), the axon (a long slender projection that conducts electrical impulses away from
the cell body), dendrites (tree-like structures that receive messages from other neurons),
and synapses (specialized junctions between neurons).
There are also several different types of neurons responsible for different tasks in
the human body. Sensory neurons carry information from the sensory receptor cells
throughout the body to the brain. Motor neurons transmit information from the brain to
the muscles of the body. Interneurons are responsible for communicating information
between different neurons in the body.

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Figure 1.1. Basic components of a neuron.
Photo credit: Science Photo Library - KTSDESIGN/Getty Images
The Central Nervous System (CNS)

The CNS comprises the brain, the spinal cord, and associated nerves that control
voluntary acts. Structurally, the brain consists of the cerebrum, cerebellum, brain stem, and
limbic system. Figures 1.2 and 1.3 show the locations of brain structures.
Figure 1.2. Anatomy of the brain.

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Adopted from: Videbeck, S.L. (2020). Psychiatric-Mental Health Nursing, 8 ed. Philadelphia
PA: Wolters Kluwer.

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Figure 1.3. The brain and its structures.

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PA: Wolters Kluwer.
Cerebrum. The cerebrum is divided into two hemispheres; all lobes and structures
are found in both halves except for the pineal body, or gland, which is located between the
hemispheres. The pineal body is an endocrine gland that influences the activities of the
pituitary gland, islets of Langerhans, parathyroids, adrenals, and gonads. The corpus
callosum is a pathway connecting the two hemispheres and coordinating their functions.
The left hemisphere controls the right side of the body and is the center for logical
reasoning and analytic functions such as reading, writing, and mathematical tasks. The right
hemisphere controls the left side of the body and is the center for creative thinking,
intuition, and artistic abilities. The cerebral hemispheres are divided into four lobes: frontal,
parietal, temporal, and occipital. Some functions of the lobes are distinct; others are
integrated. The frontal lobes control the organization of thought, body movement,
memories, emotions, and moral behavior. The integration of all this information regulates
arousal, focuses attention, and enables problem-solving and decision-making. Abnormalities
in the frontal lobes are associated with schizophrenia, attention-deficit/hyperactivity
disorder (ADHD), and dementia. The parietal lobes interpret sensations of taste and touch
and assist in spatial orientation. The temporal lobes are centers for the senses of smell and
hearing and for memory and emotional expression. The occipital lobes assist in coordinating
language generation and visual interpretation, such as depth perception.

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Cerebellum. The cerebellum is located below the cerebrum and is the center for
coordination of movements and postural adjustments. It receives and integrates
information from all areas of the body, such as the muscles, joints, organs, and other
components of the CNS. Research has shown that inhibited transmission of dopamine, a
neurotransmitter, in this area is associated with the lack of smooth coordinated movements
in diseases such as Parkinson disease and dementia.
Brain Stem. The brain stem includes the midbrain, pons, and medulla oblongata and
the nuclei for cranial nerves III through XII. The medulla, located at the top of the spinal
cord, contains vital centers for respiration and cardiovascular functions. Above the medulla
and in front of the cerebrum, the pons bridges the gap both structurally and functionally,
serving as a primary motor pathway. The midbrain connects the pons and cerebellum with
the cerebrum. It measures only 0.8 in (2 cm) length and includes most of the reticular
activating system and the extrapyramidal system. The reticular activating system influences
motor activity, sleep, consciousness, and awareness. The extrapyramidal system relays
information about movement and coordination from the brain to
the spinal nerves. The locus coeruleus, a small group of norepinephrine-producing neurons
in the brain stem, is associated with stress, anxiety, and impulsive behavior.
Limbic System. The limbic system is an area of the brain located above the brain
stem that includes the thalamus, hypothalamus, hippocampus, and amygdala (although
some sources differ regarding the structures this system includes). The thalamus regulates
activity, sensation, and emotion. The hypothalamus is involved in temperature regulation,
appetite control, endocrine function, sexual drive, and impulsive behavior associated with
feelings of anger, rage, or excitement. The hippocampus and amygdala are involved in
emotional arousal and memory. Disturbances in the limbic system have been implicated in a
variety of mental illnesses, such as the memory loss that accompanies dementia and the
poorly controlled emotions and impulses seen with
psychotic or manic behavior.
The second major component of the CNS is the spinal cord. It transmits impulses to
and from the brain and is the integrating center for the spinal cord reflexes.
Fiber Tracts. A cross section of the spinal cord reveals an area of gray matter in the
central part that is made up of the cell bodies of motor neurons and interneurons. Around
the external part of the cord is an area of white matter, so called because the fibers that
make up the area are sheathed in a white lipid substance called myelin. Ascending spinal
tracts carry sensory impulses to the brain, and descending tracts carry motor impulses from
the brain to the periphery. The center of the spinal cord contains cerebrospinal fluid and is
continuous with the ventricles in the brain.
Spinal Nerves. Thirty-one pairs of nerves emerge from the spinal cord. They do not
have names, but are identified by the level of the vertebrae from which they arise. In
general, the cervical nerves supply the upper portion of the body, including the diaphragm.
Most of the thoracic nerves supply the trunk of the body, and the lumbar and sacral nerves
supply the hips, pelvic cavity, and legs.

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Damage to the spinal cord results in loss of, or alteration in, function to the part of
the body innervated by the spinal nerves that arise from the injured area of the cord.
Regeneration of damaged neurons depends on extent and severity of the injury and
expedience in receiving treatment.
Memory, Repetition and Learning Neurotransmitters

Memory is the ability to retain information in the brain for later retrieval and
use. The brain is stimulated with input. This stimulation could come from an experience or a
brainstorm. Information travels electrically and chemically from one neuron to the next,
creating new synaptic connections. Memory is formed. LTP (long-term potentiation or long
term memory) means that the pieces are in place for later retrieval. It has been learned.
Learning is an electrical and chemical connection made between neurons in our

brains. When we are learning something new, a neuron is stimulated electrically to release
neurotransmitters. Those neurotransmitters are sent across the synapse (space between
neurons) relaying a message to the receiving neuron.
Neurotransmitters are the chemical substances that aid in the transmission of

information throughout the body. They either excite or stimulate an action in the cells
(excitatory) or inhibit or stop an action (inhibitory). These neurotransmitters fit into specific
receptor cells embedded in the membrane of the dendrite, just like a certain key shape fits
into a lock. After neurotransmitters are released into the synapse and relay the message to
the receptor cells, they are either transported back from the synapse to the axon to be
stored for later use (reuptake) or metabolized and inactivated by enzymes, primarily
monoamine oxidase (MAO). These neurotransmitters are necessary in just the right
proportions to relay messages across the synapses.

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Figure 1.4. Schematic illustration of (1) neurotransmitter (T) release; (2)

binding of transmitter to postsynaptic receptor; termination of
transmitter action by (3a) reuptake of transmitter into the presynaptic
terminal, (3b) enzymatic degradation, or (3c) diffusion away from the
synapse; and (4) binding of transmitter to presynaptic receptors for
feedback regulation of transmitter release.
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PA: Wolters Kluwer.
Many neurotransmitters exist within the central and peripheral nervous systems, but
only a limited number have implications for psychiatry. Major categories include the
cholinergics, monoamines, amino acids, and neuropeptides. Table 1.1 lists the major
neurotransmitters and their locations, functions and possible implications for mental illness.

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Table 1.1. Major neurotransmitters and their locations, functions and possible implications
for mental illness.
Possible implications
Neurotransmitter Location Functions
for mental illness
Cholinergics
Acetylcholine A major effector Implicated in sleep, Cholinergic
- the first chemical chemical within the arousal, pain perception, mechanisms may
to be identified autonomic nervous the modulation and have some role in
and proven as system (ANS), coordination of certain disorders of
neurotransmitter. producing activity at all movement, and memory motor behavior and
sympathetic and acquisition and memory, such as
parasympathetic retention. Parkinson’s,
presynaptic nerve Huntington’s, and
terminals and all Alzheimer’s diseases.
parasympathetic
postsynaptic nerve Increased levels of
terminals. acetylcholine have
It is highly significant in been associated with
the neurotransmission depression.
that occurs at the
junctions of nerve and
muscles. In the CNS,
acetylcholine neurons
innervate the cerebral
cortex, hippocampus,
and limbic structures.
The pathways are
especially dense
through the area of the
basal ganglia in the
brain.
Monoamines
Norepinephrine - Found in the ANS at the May have a role in the The mechanism of
the sympathetic regulation of mood, in norephinephrine
neurotransmitter postsynaptic nerve cognition and perception, transmission has
associated with the terminals. in cardiovascular been implicated in
“fight or flight” In the CNS, functioning, and in sleep certain mood
syndrome of norepinephrine and arousal. disorders such as
symptoms that pathways originate in depression and
occurs in response the pons and medulla mania, in anxiety
to stress. and innervate the states, and in
thalamus, dorsal schizophrenia
hypothalamus, limbic
system, hippocampus, Levels of the
cerebellum, and neurotransmitter are
cerebral cortex. thought to be
decreased in
depression and
increased in mania,

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for mental illness
anxiety states, and in
schizophrenia.
Dopamine - Arise from the Involved in the regulation Decreased levels of

derived from the midbrain and of movements and dopamine have been
amino acid hypothalamus and coordination, emotions, implicated in the
tyrosine and may terminate in the frontal voluntary decision- etiology of
play a role in cortex, limbic system, making ability, and Parkinson’s disease
physical activation basal ganglia, and because of its influence and depression
of the body. thalamus. Dopamine on the pituitary gland, it
neurons in the inhibits the release of Increased levels of
hypothalamus prolactin. dopamine are
innervate the posterior associated with
pituitary and those mania
from the posterior
hypothalamus project
to the spinal cord.
Serotonin - derived Originates from cell May play a role in sleep Increased levels of
from the dietary bodies located in the and arousal, libido, serotonin have been
amino acid pons and medulla, and appetite, mood, implicated in
tryptophan. project to areas aggression, and pain schizophrenia and
including the perception. anxiety states
hypothalamus,
thalamus, limbic Decreased levels
system, cerebral have been associated
cortex, cerebellum, and with depression
spinal cord. Serotonin
that is not returned to
be stored in the axon
terminal vesicles is
catabolized by the
enzyme monoamine
oxidase.
Histamine – play a Highest concentrations The exact processes Some data suggest
significant role in found within various mediated by histamine that histamine may
mediating allergic regions of the within the CNS are play a role in
and inflammatory hypothalamus. unclear. depressive illness.
reactions; role in
the CNS as a
neurotransmitter
has only recently
been confirmed,
and only limited
information is
available.

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for mental illness
Amino acids
Gamma Widespread Interrupts the Decreased levels of
Aminobutyric Acid distribution in the progression of the GABA have been
(GABA) - central nervous system, electrical impulse at the implicated in the
associated with with high synaptic junction, etiology of anxiety
short inhibitory concentrations in the producing a significant disorders, movement
interneurons, hypothalamus, slowdown of body disorders such as
although some hippocampus, cortex, activity. Huntington’s disease,
long-axon cerebellum, and basal and various forms of
pathways within ganglia of the brain; in epilepsy.
the brain have now the gray matter of the
been identified. dorsal horn of the
spinal
cord; and in the retina.
Glutamate - Found in the pyramidal Functions in the relay of Increased receptor

neurotransmitter cells of the cortex, sensory information and activity has been
that appears to be cerebellum, and the in the regulation of implicated in the
primarily excitatory primary sensory various motor and spinal etiology of certain
in nature. afferent systems. It is reflexes. neurodegenerative
also found in the disorders,
hippocampus, such as Parkinson’s
thalamus, disease.
hypothalamus, and
spinal cord. Decreased receptor
activity can induce
psychotic behavior.
Neuropeptides
Endorphins and Found in various With their natural Modulation of
Enkephalins - concentrations in the morphine-like properties, dopamine activity by
neurotransmitters hypothalamus, thought to have a role in opioid peptides may
sometimes called thalamus, limbic pain modulation indicate some link to
opioid peptides. structures, midbrain, the symptoms of
and brainstem. schizophrenia.
Enkephalins are also
found in the
gastrointestinal (GI)
tract.
Somatostatin -also Found in the cerebral As a neurotransmitter, it High concentrations

called the growth cortex, hippocampus, exerts both stimulatory of somatostatin have
hormone-inhibiting thalamus, basal ganglia, and inhibitory effects. been reported in
hormone. brainstem, and spinal brain specimens of
cord. Depending on the part of clients with
the brain being affected, Huntington’s disease
it has been shown to
stimulate dopamine, Low concentrations

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for mental illness
serotonin, have been reported
norepinephrine, and in clients with
acetylcholine and to Alzheimer’s disease.
inhibit norepinephrine,
histamine, and
glutamate.
Also acts as a
neuromodulator for
serotonin in the
hypothalamus, thereby
regulating its release (i.e.,
determining whether it is
stimulated or inhibited).
ACTIVITY 1. Based on what you have learned so far, briefly explain

how neurotransmitters affect human behavior?
Submit your output for this activity in the submission folder 1 of this lesson.
LEARNING INPUT 2.
Concepts and Patterns of Human Behavior
Learning input 2 presents the fundamental concepts needed to understand human

behavior. Specifically, this includes family dynamics, patterns of behavior, concepts of
human behavior, concepts of mental health and mental illness, and crisis.
Family Dynamics
Family dynamics refers to the patterns of interactions among relatives, their roles
and relationships, and the various factors that shape their interactions.
Because family members rely on each other for emotional, physical, and economic support,
they are one of the primary sources of relationship security or stress.
Healthy family dynamics afford a person better health and well-being, as well as
lower rates of depression and disease throughout a lifetime. On the other hand, individuals
who grow up in households with unhealthy family dynamics (abuse, neglect, overly strict
parenting, overly loose parenting, poor communication, insecure attachment style, etc.) are

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more likely to develop mental health disorders and may experience more difficulty within
relationships.
Functional Family. In a functional family, parents strive to create an environment

in which everyone feels safe and respected. A positive home requires parents to
set and uphold rules, but not resort to overly rigid regulation of any one person's
behavior. In a healthy household, slights and misbehaviors are readily addressed,
and boundaries are clear and consistent, all of which help avoid disharmony in
the longer term. While this sounds easy, it can be hard to achieve in practice.
Dysfunctional Family. Peace and harmony may be the goal for most families, but
dysfunction is common and insidious, and arrives in many forms. Family quarrels,
grudges and estrangement can have lasting effects, sometimes following
members into old age. When one family member contends with a problem such
as alcoholism, the entire household is impacted. In a dysfunctional home, there
is normally no sense of unity or empathy or boundaries, and members can be
highly critical of one another.
The reasons for conflict are many and varied. The dysfunction may start
with something as simple as a parent who models unhealthy behavior. Another
obvious reason is poor communication; unstable households rarely enjoy
positive interaction. The unsteady home is not a safe place for its members.
Often dysfunctional households suffer any number of problems,
including domestic violence, substance abuse, neglect, or untreated mental
illness.
Just one member can tilt the family dynamic into dysfunction, or
worse, estrangement. Often, it is the parent who behaves destructively. The
parent may have underlying personality traits that result in harmful family
dynamics. The destructive parent may try to manipulate others; demand support
but offer no support; remain inconsistent with rules and operate unfairly. They
can also be judgmental, critical, and unaccountable. All of which harms the
family unit, maybe for life or even generations.
Patterns of Behavior
Charles Darwin founded the scientific study of behavior, and showed by many
examples that behavior is an adaptation to environmental demands, and can increase the
chances of species survival. Random movement, reflex, instinct, and habit are behavioral
patterns showed by animals, including humans, in response to environmental cues.
Random movements and impulses. These are regarded as raw materials for
larger integrated behavior patterns. They are termed random because as
movements and impulses, they do not appear to be directed to any particular
adjustment end. Random behavior is a characteristic of early childhood and does
not normally appear to any considerable extent in older children or in adults. If it
does occur in the latter, it is a sign of temporary nervousness or of chronic neural
disorganization and is distinctly pathological. Normally random behavior of all

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kinds, except possibly in part that of the higher cortical processes, should
become integrated and transformed into definite and economical patterns as
the individual reaches the age when one ordinarily makes an effective
adjustment to his environments.
While random behavior is not purposive and is not functional or adaptive

in any specific sense, it is not without a general function. It is the raw material
out of which habits are to a large extent built. Note that the child is moving his
head or hands or in kicking in a random way brings parts of his body into
contacts with objects and establishes useful stimulus-response processes which
thereupon are repeated, at first with little or no awareness of their significance,
but later frequently in a highly purposive way. In this manner the child learns to
reach out for objects which has given it satisfaction, or it acquires the definite
coordination of crawling and walking.
Reflexes. Reflexes are both highly specific and adaptive. Just like random
movements, reflexes serve as raw materials for the building of habit
mechanisms, but the acquired behavior built out of reflexes is necessarily more
limited in scope and more predetermined than that arising out of the raw
materials of the random movements, because the latter are themselves less
fixed and more freely modified in the habit building process. Reflex actions, such
as the knee-jerk reflex tested by doctors and the sucking reflex of human infants,
are very simple innate behaviors.
Instincts. Instincts differ from reflexes primarily in their greater degree of

complexity. Like reflexes they are definite and apparently inherited stimulus-
response or neural behavior mechanisms, by means of which a specific stimulus
produces a specific and definite response. They also normally operate without
the exercise of consciousness. If consciousness appears in the behavior
processes it is because the original or inherited behavior pattern has been
modified or is being interfered with in the adjustment situation.
Instincts are not purposive, but like reflexes, they are adaptive. They
serve a definite function in the adjustment process. Like the reflexes, they
constitute a method of standardizing and economizing the behavior of organisms
in adjusting to fairly permanent and constant environmental conditions. In this
way, they aid in preserving the integrity of the organism under stable
environmental conditions, and prevent its destruction by random responses to
stimuli.
Habits. The acquired behavior patterns, which are dominant in modern human
behavior, do not arise out of nothing. They are developed from underlying
behavior patterns which can be organized into habits and habit complexes by the
environmental pressure. These underlying patterns, as previously discussed, are
random movements, reflexes, and instincts. Acquired behavior complexes are
integrated within the individual organism and, are properly speaking, individual
habits.

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The method of acquiring habits is that known as the conditioning of

responses. It has long been known that old responses may be adjusted to new
stimuli and that new responses may be integrated and adapted to old stimuli.
Concepts of Human Behavior

APA Dictionary of Psychology defines behavior as an organism's activities in response
to external or internal stimuli, including objectively observable activities, introspectively
observable activities, and non-conscious processes.
In scientific research, human behavior is viewed as a complex interplay of three

components: (1) actions, (2) cognition, and (3) emotions.
Actions are behavior. An action denotes everything that can be observed, either
with bare eyes or measured by physiological sensors. Think of an action as an
initiation or transition from one state to another – at a movie set, the director
shouts “action” for the next scene to be filmed. Behavioral actions can take place
on various time scales, ranging from muscular activation to sweat gland activity,
food consumption, or sleep.
Cognitions are behavior. Cognitions describe thoughts and mental images you
carry with you, and they can be both verbal and nonverbal. “I have to remember
to buy groceries,” or “I’d be curious to know what she thinks of me,” can be
considered verbal cognitions. In contrast, imagining how your house will look like
after remodeling could be considered a nonverbal cognition.
Emotions are behavior. An emotion is any relatively brief conscious experience

characterized by intense mental activity, and a feeling that is not characterized
as resulting from either reasoning or knowledge. This usually exists on a scale,
from positive (pleasurable) to negative (unpleasant).
Actions, cognitions and emotions do not run independently of each other – their
proper interaction enables you to perceive the world around you, listen to your inner wishes
and respond appropriately to people in your surroundings. However, it is hard to tell what
exactly is cause and effect – turning your head (action) and seeing a familiar face might
cause a sudden burst of joy (emotion) accompanied by an internal realization (cognition).
To understand the behavior of a person, you have to understand what that person
will do if something happens. Behavior is mostly influenced by the nature of the person and
the nature of the situation.
Based on the way people act or behave in different situations and in response to
different stimuli, human behavior can be divided into different types. Listed below are some
known and important types of human behavior.

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 Molecular and Moral Behavior

Molecular Behavior: It is an unexpected behavior that occurs without
thinking. One example is suddenly closing eyes when something goes to the
eyes.
Moral Behavior: Unlike molecular behavior, this type of behavior occurs after
thinking. For example, a person changes the way when she or he sees a
harmful thing.
 Overt & Covert Behavior
Overt Behavior: It is a visible type of behavior that can occur outside of

human beings. Eating food, riding on a bicycle, and playing football are some
examples.
Covert Behavior: Unlike overt behavior, this type of behavior is not visible.
Thinking is a good example of covert behavior because no one can see us
thinking.
 Voluntary and Involuntary Behavior
Voluntary Behavior: It is a type of behavior that depends on human want. We

can characterize walking, speaking, and writing as voluntary behaviors.
Involuntary Behavior: Unlike voluntary behavior, this type occurs naturally

and without thinking. Breathing air is a perfect example of involuntary
behavior.
Concepts of Mental Health and Mental Illness
Mental health and mental illness are difficult to define precisely. People who can
carry out their roles in society and whose behavior is appropriate and adaptive are viewed
as healthy. Conversely, those who fail to fulfill roles and carry out responsibilities or whose
behavior is inappropriate are viewed as ill.
Moreover, the concepts of mental health and mental illness are culturally defined.
The culture of any society strongly influences its values and beliefs, and this, in turn, affects
how that society defines health and illness. What one society may view as acceptable and
appropriate, another society may see as maladaptive and inappropriate.
Mental Health. The World Health Organization defines health as a state of complete
physical, mental, and social wellness, not merely the absence of disease or infirmity. This
definition emphasizes health as a positive state of well-being. People in a state of emotional,
physical, and social well-being fulfill life responsibilities, function effectively in daily life, and
are satisfied with their interpersonal relationships and themselves.

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The American Psychiatric Association (APA) (2003) defines mental health as “a state
of being that is relative rather than absolute. The successful performance of mental
functions shown by productive activities, fulfilling relationships with other people, and the
ability to adapt to change and to cope with adversity.”
Also, Townsend (2011) defines mental health as “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.
Videbeck (2014) refutes however, that there is no single universal definition of

mental health that exists. Because each person can have a different view or interpretation
of behavior (depending on his or her values and beliefs), the determination of mental health
may be difficult. But she believes that in most cases, mental health is a state of emotional,
psychological, and social wellness evidenced by satisfying interpersonal relationships,
effective behavior and coping, positive self-concept, and emotional stability.
Mental Illness. As mentioned earlier, a universal concept of mental illness is difficult

to define because of the cultural factors that influence such a concept. However, certain
elements are associated with individuals’ perceptions of mental illness, regardless of
cultural origin.
Horwitz (2002 as cited in Townsend, 2011), identifies two of these elements as

incomprehensibility and cultural relativity. Incomprehensibility relates to the inability of the
general population to understand the motivation behind the behavior. When observers are
unable to find meaning or comprehensibility in behavior, they are likely to label that
behavior as mental illness. The element of cultural relativity, on the other hand, considers
that the rules, conventions, and understandings used to interpret behavior, are conceived
within an individual’s own particular culture. Behavior is categorized as “normal” or
“abnormal” according to one’s cultural or societal norms. Therefore, a behavior that is
recognized as evidence of mental illness in one society may be viewed as normal in another
society and vice versa.
Mental illness, as outlined and described in the Diagnostic and Statistical Manual of
Mental Disorders, fifth edition (DSM-5), includes disorders that affect mood, behavior, and
thinking, such as depression, schizophrenia, anxiety disorders, and addictive disorders.
Mental disorders often cause significant distress or impaired functioning or both.

Individuals experience dissatisfaction with self, relationships, and ineffective coping. Daily
life can seem overwhelming or unbearable. Individuals may believe that their situation is
hopeless.
The concepts of needs, frustration and conflict, anxiety and anxiety responses, and
patterns of adaptation will also be discussed in this learning input in order to further
understand the concepts of mental health and mental illness.
Needs. Needs play an important role in the motivation of human behavior. According
to Abraham Maslow, a need is a relatively lasting condition or feeling that requires relief or

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satisfaction, and it tends to influence action over the long term. Some needs (like hunger)
may decrease when satisfied, while others (like curiosity) may not. Maslow further defines
motivation as the process of satisfying certain needs that are required for long-term
development.
Maslow formulated the hierarchy of needs, in which he used a pyramid to arrange

and illustrate the basic drives or needs that motivate people. The most basic needs—the
physiologic needs of food, water, sleep, shelter, sexual expression, and freedom from pain—
must be met first. The second level involves safety and security needs, which include
protection, security, and freedom from harm or threatened deprivation. The third level is
love and belonging needs, which include enduring intimacy, friendship, and acceptance. The
fourth level involves esteem needs, which include the need for self-respect and esteem
from others. The highest level is self-actualization, the need for beauty, truth, and justice.
Maslow hypothesized that the basic needs at the bottom of the pyramid would
dominate the person’s behavior until those needs were met, at which time the next level of
needs would become dominant. For example, if needs for food and shelter are not met,
they become the overriding concern in life; the hungry person risks danger and social
ostracism to find food.
Maslow was among the number of theorists who have attempted to define the
concept of mental health. He emphasized an individual’s motivation in the continuous quest
for self-actualization. Maslow described self-actualization as the state of being
“psychologically healthy, fully human, highly evolved, and fully mature.” He believed that
healthy, or self-actualized, individuals possessed the following characteristics:
 An appropriate perception of reality
 The ability to accept oneself, others, and human nature
 The ability to manifest spontaneity
 The capacity for focusing concentration on problem-solving
 A need for detachment and desire for privacy
 Independence, autonomy, and a resistance to enculturation
 An intensity of emotional reaction
 A frequency of “peak” experiences that validate the worthwhileness, richness, and
beauty of life
 An identification with humankind
 The ability to achieve satisfactory interpersonal relationships
 A democratic character structure and strong sense of ethics
 Creativeness
 A degree of nonconformance
Frustrations. One major element of maladjustment that is consistently repeated in

almost all the causes of maladjusted behavior is frustration. Frustration refers to an
emotional tension that results from the blocking of a need or desire. Frustration results
when your motives are thwarted either by some obstacle that blocks or impedes your
progress towards a desired goal or by the absence of an appropriate goal.

Chronic) | 18
What causes frustration? The frustration you experience can be seen as the result of two
types of goal blockage, i.e. internal and external sources of frustration.
Internal sources of frustration usually involve physical abnormality or defects, conflicting

desires or aims, individual’s morality and high ideals, high level of aspiration, lack of
persistence and sincerity in efforts.
Physical abnormality or defects: Too big or too small stature, very heavy or thin
body, ugly face, dark complexion, bodily defects cause frustration.
Conflicting desires or aims: Frustration happens when mutual aims and goals are
obstructed. Eg: A man may be interested in marrying the woman he loves but he
wishes to go abroad by marrying another woman.
Individual’s morality and high ideals: An individual’s moral standards, code of

ethics and high ideals may become a source of frustration, as the person is
always caught between his superego and id.
Too high level of aspirations. One may aspire very high in spite of one’s
capabilities or human limitations. E.g., A person dreams to become the captain of
a soccer team but does not even know the basics of the game.
Lack of persistence and sincerity in efforts: Frustration may happen due to

weakness in putting continuous persistence and efforts with courage,
enthusiasm, and will power at one’s command. E.g., Reading a book without
interest and complaining that the book is understandable.
The second type of frustration results from external causes that involve conditions
outside the person such as physical, social and societal, and economic factors.
Physical factors: These may include natural calamities such as floods, tsunami,
earthquakes, fire accidents, etc. Obstacles such as traffic jams, crowded lines at
the supermarket, droughts that destroy a farmer’s crops, noise that prevent
concentration, floods that delay travels are also physical factors that can cause
frustration.
Social and societal factors: The rules and regulations set by your parents, society,
culture and belief may control the desire and motive of people; as well as the
restrictions imposed by other people’s laws, customs, and norms.
Economic factors: Financial factors such as unemployment, lack of food and

water, other severe economic deprivation all result to frustration.
What are the responses to frustration? Some of the typical responses to frustration
include anger, quitting (burn out or giving up), loss of self-esteem and self-confidence, stress
and depression.

Chronic) | 19
Anger: Direct anger and aggression is expressed toward the object perceived as
the cause of the frustration. If a machine does not work, you might hit it or kick
it. If someone gets in your way, you could verbally threaten them or push them
aside. If the source of the frustration is too powerful or threatening for direct
aggression, displaced aggression is often used. The aggression is redirected
toward a less threatening and more available object.
Giving up: Giving up on a goal can be productive if the goal is truly out of
reach. However, more often giving up (quitting or being apathetic) is another
form of giving in to frustration. When repeatedly frustrated, people can drop out
of school, quit jobs, or move away. Apathy is giving up all of your goals, so you
cannot be frustrated by trying to reach them.
Loss of confidence: Loss of confidence is a frequent side effect of giving up and

not fulfilling your goal. A loss of self-confidence and self-esteem means that If
you quit once, then the next time you plan a goal, you may not be able to
accurately assess your ability to carry it out and you stop trusting ourselves and
your own abilities. This became a self-fulfilling and self-destructive attitude.
Stress: Stress is the "wear and tear" your body and mind experience as you adjust
to the frustrations and to your continually changing environment. Too
frequently, extreme, or prolonged frustration and stress strains you and
generates distress signals. Your body experiences distress signals in a variety of
ways, often in the form of: irritability, anger, fatigue, anxiety,
headaches, depression, stomachaches, hypertension, migraines, ulcers, heart
attacks, or colitis.
Depression: Depression can affect almost every aspect of your life. It affects
people of all ages, income, race, and cultures. Depression can affect your
sleeping and eating habits, your feelings and perception about yourself and
others, and your interactions and relationship with others.
Other reactions: Abuse of drugs or alcohol is self-destructive and usually

ineffective attempt at dealing with frustration. Whenever the immediate effects
of the addictive behavior wear off, users find themselves back in the same, or
even worse, frustrating situation.
Life is full of frustrations. From the minor irritations of losing something to the major
problem of continued failure towards a desired goal. Since many of the things you truly
want require a degree of frustration, being able to manage frustration is required in order to
allow you to maintain a state of emotional, psychological, and social wellness.
Conflicts. After our discussion of frustration, let us discuss the difference between
conflict and frustration. Yes, there is a difference between conflict and frustration.
Frustration is the product or the consequence of the dissatisfaction of needs, whereas,
conflict is the process, or one of the factors responsible for causing frustration.

Chronic) | 20
Conflict is the operation of two incompatible action systems, it may be drives; needs,
values, tendencies and impulses. The individual finds it difficult to make a choice between
two conflicting situations.
A conflict is caused under two situations. First, conflict arises when there is an urge
to fulfill the two equally important objectives, needs, drives, values, tendencies and
impulses. Second, conflict arises when two different goals are set to fulfill a single need.
Conflicts are classified into four types. These are the approach-approach conflict,
approach-avoidance conflict, avoidance-avoidance conflict, and multiple approach-
avoidance conflict.
Approach-approach conflict: It is a situation wherein the individual is caught

between two mutually exclusive goals which are desirable and also are difficult
to realize simultaneously. This is exemplified in the following situations: reading
an interesting novel or going for games; selection of one girl for marriage from
two beautiful girls. This type of conflict may lead to some hesitancy but rarely to
great distress.
Approach - avoidance conflict:

The conflict occurs when a person is both attracted and deterred by the same
object, person, or situation. The goal has both positive and negative values that
makes it appealing and unappealing simultaneously. E.g., to marry or not to
marry; to purchase something or not. This is difficult to resolve and gives rise to
anxieties and complexes.
Avoidance-avoidance conflict: It is a situation wherein an individual is motivated

to avoid both the goals. This type of conflict occurs when there are two
undesirable situations but cannot avoid one without encountering the other. The
person must then choose between the two equally undesirable or unattractive
goals. E.g., a situation where you have to decide between doing unwanted
homework (avoidance) or doing unwanted house chores (avoidance).
Multiple approach-avoidance conflict. It results when a person is faced with a

number of alternatives, each of which has both attracting and repelling aspects.
Since the tendency is to either approach or avoid each of the goals, this pattern
is called double approach-avoidance. E.g., choosing a house in a rural area means
fresh air, room to live, peace and quiet environment. It also means hours of
commuting to work in and long distances from city amenities and cultural events.
Anxiety and Anxiety Response. Both frustration and conflict can result to stress and
anxiety. As previously mentioned, stress refers to the "wear and tear" our body and mind
experiences as we adjust to the frustrations and to our continually changing
environment. Anxiety, on the other hand, is a vague feeling of dread or apprehension. It is

Chronic) | 21
a response to external or internal stimuli that can have behavioral, emotional, cognitive, and
physical symptoms.
Anxiety is distinguished from fear, which is feeling afraid or threatened by a clearly

identifiable external stimulus that represents danger to the person. Anxiety is unavoidable
in life and can serve many positive functions such as motivating the person to take action to
solve a problem or to resolve a crisis. It is considered normal when it is appropriate to the
situation and dissipates when the situation has been resolved.
Anxiety has both healthy and harmful aspects, depending on its degree and duration as well
as on how well the person copes with it. Anxiety has four levels: mild, moderate, severe, and
panic (Table 2.1). Each level causes both physiological and emotional changes in the person.
Table 2.1. The four levels of anxiety.

Anxiety Level Psychological Responses Physiological Responses
Mild Wide perceptual field Restlessness
Sharpened senses Fidgeting
Increased motivation GI “butterflies”
Effective problem-solving Difficulty sleeping
Increased learning ability Hypersensitivity to noise
Irritability
Moderate Perceptual field narrowed to Muscle tension
immediate task Diaphoresis
Selectively attentive Pounding pulse
Cannot connect thoughts or events Headache
independently Dry mouth
Increased use of automatisms High voice pitch
Faster rate of speech
GI upset
Frequent urination
Severe Perceptual field reduced to one Severe headache
detail or scattered details Nausea, vomiting, and diarrhea
Cannot complete tasks Trembling
Cannot solve problems or learn Rigid stance
effectively Vertigo
Behavior geared toward anxiety Pale
relief and is Tachycardia
usually ineffective Chest pain
Doesn’t respond to redirection
Feels awe, dread, or horror
Cries
Ritualistic behavior
Panic Perceptual field reduced to focus May bolt and run or totally
on self immobile
Cannot process any environmental and mute
stimuli Dilated pupils
Distorted perceptions Increased blood pressure and pulse
Loss of rational thought Flight, fight, or freeze
Doesn’t recognize potential danger

Chronic) | 22
Can’t communicate verbally

Possible delusions and
hallucination
May be suicidal
Mild anxiety is a sensation that something is different and warrants special

attention. Sensory stimulation increases and helps the person focus attention to learn, solve
problems, think, act, feel, and protect him or herself. Mild anxiety often motivates people to
make changes or engage in goal-directed activity. For example, it helps students focus on
studying for an examination.
Moderate anxiety is the disturbing feeling that something is definitely wrong; the
person becomes nervous or agitated. In moderate anxiety, the person can still process
information, solve problems, and learn new things with assistance from others. He or she
has difficulty concentrating independently but can be redirected to the topic. For example,
the nurse might be giving preoperative instructions to a client who is anxious about the
upcoming surgical procedure. As the nurse is teaching, the client’s attention wanders, but
the nurse can regain the client’s attention and direct him or her back to the task at hand.
As the person progresses to severe anxiety and panic, more primitive survival skills
take over, defensive responses ensue, and cognitive skills decrease significantly. A person
with severe anxiety has trouble thinking and reasoning. Muscles tighten, and vital signs
increase. The person paces; is restless, irritable, and angry; or uses other similar emotional–
psychomotor means to release tension. In panic, the emotional–psychomotor realm
predominates with accompanying fight, flight, or freeze responses. Adrenaline surge greatly
increases vital signs. Pupils enlarge to let in more light, and the only cognitive process
focuses on the person’s defense
Anxiety disorders are diagnosed when anxiety no longer functions as a signal of

danger or a motivation for needed change, but becomes chronic and infiltrates major
portions of the person’s life, resulting in maladaptive behaviors and emotional disability.
Patterns of Adaptation. Coping to stress and anxiety is very crucial to prevent mental
problems to occur. Coping refers to the deliberate, planned, and psychological effort to
manage stressful demands (Boyd, 2008). The coping process may inhibit or override the
innate urge to act.
Positive coping leads to adaptation, which is characterized by a balance between

health and illness, a sense of well-being, and maximum social functioning. When a person
does not cope positively, maladaptation occur that can shift the balance toward illness, a
diminished self-concept, and deterioration in social functioning.
As mentioned above, adaptation or a lack of it, affects three important areas: health,
psychological well-being, and social functioning. A period of stress may compromise any or
all of these areas. If a person copes successfully with stress, he or she returns to previous
level of adaptation. Successful coping results in an improvement in health, wellbeing and
social functioning. Unfortunately, at times, maladaptation occurs. A maladaptation in any

Chronic) | 23
one area can negatively affect the others. For instance, the appearance of psychiatric
symptoms can cause problems in performance in the work environment, that in turn elicit a
negative self-concept.
There are two types of coping: problem-focused, which actually changes the person-
environment relationship; and emotion-focused, which changes the meaning of the
situation. In problem-focused coping, the person attacks the source of stress by eliminating
it or changing its effects. In emotion-focused coping, the person reinterprets the situation,
reducing the stress and the need for additional coping without changing the actual person-
environment relationship.
No one coping strategy is best for all situations. Some situations require a
combination of strategies and activities. Ideally, a person can cope with a stressful situation
by matching the resources that are needed with the events that are unfolding. Social
support can be critical in helping people cope with difficult situations. According to Lazarus
(1999, as cited in Boyd, 2008), successful coping with life stresses is linked to quality of life,
as well as to physical and mental health.
Crisis
Stressful situations are a part of everyday life. Any stressful situation can precipitate
a crisis. Crises result in a disequilibrium from which many individuals require assistance to
recover.
Caplan (1964 as cited in Townsend, 2011), identified a number of characteristics
upon which the concept of crisis is based: They include the following:
 Crisis occurs in all individuals at one time or another and is not necessarily
equated with psychopathology.
 Crises are precipitated by specific identifiable events.
 Crises are personal by nature. What may be considered a crisis situation by one
individual may not be so for another.
 Crises are acute, not chronic, and will be resolved in one way or another within a
brief period.
 A crisis situation contains the potential for psychological growth or deterioration.
Individuals who are in crisis feel helpless to change. They do not believe they have
the resources to deal with the precipitating stressor. Levels of anxiety rise to the point that
the individual becomes nonfunctional, thoughts become obsessional, and all behavior is
aimed at relief of the anxiety being experienced. The feeling is overwhelming and may affect
the individual physically as well as psychologically.
The development of a crisis situation follows a relatively predictable course. Caplan

(1964, as cited in Townsend, 2011) outlined four specific phases through which individuals
progress in response to a precipitating stressor and that culminate in the state of acute
crisis.
Phase 1: The individual is exposed to a precipitating stressor. Anxiety increases;

previous problem-solving techniques are employed.

Chronic) | 24
Phase 2: When previous problem-solving techniques do not relieve the stressor,

anxiety increases further. The individual begins to feel a great deal of discomfort
at this point. Coping techniques that have worked in the past are attempted,
only to create feelings of helplessness when they are not successful. Feelings of
confusion and disorganization prevail.
Phase 3: All possible resources, both internal and external, are called on to
resolve the problem and relieve the discomfort. The individual may try to view
the problem from a different perspective, or even to overlook certain aspects of
it. New problem-solving techniques may be used, and, if effectual, resolution
may occur at this phase, with the individual returning to a higher, a lower, or the
previous level of premorbid functioning.
Phase 4: If resolution does not occur in previous phases, the tension mounts
beyond a further threshold or its burden increases over time to a breaking point.
Major disorganization of the individual with drastic results often occurs. Anxiety
may reach panic levels. Cognitive functions are disordered, emotions are labile,
and behavior may reflect the presence of psychotic thinking.
These phases are congruent with the concept of “balancing factors” as described by
Aguilera (1998, as cited in Townsend, 2011). These factors affect the way in which an
individual perceives and responds to a precipitating stressor. A schematic of these balancing
factors is illustrated in Figure 2.1. The paradigm set forth by Aguilera suggests that whether
an individual experiences a crisis in response to a stressful situation depends upon the
following three factors:
 The individual’s perception of the event: If the event is perceived realistically,
the individual is more likely to draw upon adequate resources to restore
equilibrium. If the perception of the event is distorted, attempts at problem-
solving are likely to be ineffective, and restoration of equilibrium goes
unresolved.
 The availability of situational supports: Situational supports are those

persons who are available in the environment and who can be depended on
to help solve the problem. Without adequate situational supports during a
stressful situation, an individual is most likely to feel overwhelmed and alone.
 The availability of adequate coping mechanisms: When a stressful situation

occurs, individuals draw upon behavioral strategies that have been successful
for them in the past. If these coping strategies work, a crisis may be diverted.
If not, disequilibrium may continue and tension and anxiety increase.

Chronic) | 25
Figure 2.1. The effects of balancing factors in a stressful event.

Adopted from:Townsend, M.C. (2011) Essentials of Psychiatric Mental Health
th
Nursing: Concept of care in evidence-based practice, 5
edition. Philadelphia PA: F.A. Davis Company.
Further, Baldwin (1978, as cited in Townsend, 2011) identified six classes of

emotional crises, which progress by degree of severity. As the measure of psychopathology
increases, the source of the stressor changes from external to internal. Take note of the
examples presented for each of the different classes which was also adopted in Townsend,
2011.
Class 1: Dispositional Crises: An acute response to an external situational

stressor.
Example: Nancy and Ted have been married for 3 years and have a 1-year-old
daughter. Ted has been having difficulty with his boss at work. Twice during the
past 6 months, he has exploded in anger at home and has become abusive with
Nancy. Last night he became angry that dinner was not ready when he expected.
He grabbed the baby from Nancy and tossed her, screaming, into her crib. He hit
and punched Nancy until she feared for her life. This morning when he left for
work, she took the baby and went to the emergency department of the city
hospital, not having anywhere else to go.

Chronic) | 26
Class 2: Crises of Anticipated Life Transitions: Normal life-cycle transitions that

may be anticipated over which the individual may feel a lack of control.
Example: College student J.T. is placed on probationary status because of low
grades this semester. His wife had a baby and had to quit her job. He increased
his working hours from part time to full time to compensate and therefore had
little time for studies. He presents himself to the student-health nurse
practitioner complaining of numerous vague physical complaints.
Class 3: Crises resulting from traumatic stress: Crises precipitated by unexpected

external stresses over which the individual has little or no control and from
which he or she feels emotionally overwhelmed and defeated.
Example: Sally was a waitperson whose shift ended at midnight. Two weeks ago,
while walking to her car in the deserted parking lot, she was abducted by two
men with guns, taken to an abandoned building, and raped and beaten. Since
that time, her physical wounds have nearly healed. However, Sally cannot be
alone; is constantly fearful; relives the experience in flashbacks and dreams; and
is unable to eat, sleep, or work at her job in the restaurant. Her friend offers to
accompany her to the mental health clinic.
Class 4: Maturational/ developmental crises: Crises that occur in response to
situations that trigger emotions related to unresolved conflicts in one’s life.
These crises are of internal origin and reflect underlying developmental issues
that involve dependency, value conflicts, sexual identity, control, and capacity
for emotional intimacy.
Example: Bob is 40 years old. He has just been passed over for a job promotion
for the third time. He has moved many times within the large company for which
he works, usually after angering and alienating himself from the supervisor. His
father was domineering and became abusive when Bob did not comply with his
every command. Over the years, Bob’s behavioral response became one of
passive-aggressiveness—first with his father, then with his supervisors. This third
rejection has created feelings of depression and intense anxiety in Bob. At his
wife’s insistence, he has sought help at the mental health clinic.
Class 5: Crises Reflecting Psychopathology: Emotional crises in which preexisting

psychopathology has been instrumental in precipitating the crisis or in which
psychopathology significantly impairs or complicates adaptive resolution.
Examples of psychopathology that may precipitate crises include borderline
personality, severe neuroses, characterological disorders, or schizophrenia.
Example: Sonja, age 29, was diagnosed with borderline personality at age 18. She
has been in therapy on a weekly basis for 10 years, with several hospitalizations
for suicide attempts during that time. She has had the same therapist for the
past 6 years. This therapist told Sonja today that she is to be married in 1 month
and will be moving across the country with her new husband. Sonja is distraught
and experiencing intense feelings of abandonment. She is found wandering in

Chronic) | 27
and out of traffic on a busy expressway, oblivious to her surroundings. Police

bring her to the emergency department of the hospital.
Class 6: Psychiatric Emergencies: Crisis situations in which general functioning

has been severely impaired and the individual rendered incompetent or unable
to assume personal responsibility. Examples include acutely suicidal individuals,
drug overdoses, reactions to hallucinogenic drugs, acute psychoses,
uncontrollable anger, and alcohol intoxication.
Example: Jennifer, age 16, had been dating Joe, the star high school football
player, for 6 months. After the game on Friday night, Jennifer and Joe went to
Jackie’s house, where a number of high school students had gathered for an
after-game party. No adults were present. About midnight, Joe told Jennifer that
he did not want to date her anymore. Jennifer became hysterical, and Jackie was
frightened by her behavior. She took Jennifer to her parent’s bedroom and gave
her a Valium from a bottle in her mother’s medicine cabinet. She left Jennifer
lying on her parent’s bed and returned to the party downstairs. About an hour
later, she returned to her parent’s bedroom and found that Jennifer had
removed the bottle of Valium from the cabinet and swallowed all of the tablets.
Jennifer was unconscious and Jackie could not awaken her. An ambulance was
called and Jennifer was transported to the local hospital.
As the measure of psychopathology increases, the source of the stressor changes

from external to internal. The type of crisis determines the method of intervention selected,
which will be discussed later in the course.

Chronic) | 28
ACTIVITY 2. Considering what you have learned at this point, do

the following tasks:
Task #1: Present a situation in which you have personally

experience frustration. Identify its cause and your responses to
it. Enumerate also ways that you can do in order to manage
such frustration in case it happens again.
Task #2: Choose one class of crises; and create your own
scenario which depicts the chosen class.
When you are finished, upload your work in the submission

folder 2 of this lesson.
WRAP-UP ACTIVITY. Considering what you have learned in this lesson, fill
up the last column of the K-W-L chart to evaluate what you have learned
from the concepts discussed in this lesson!
WHAT I KNOW WHAT I WANT TO WHAT I LEARNED

KNOW
This ends our discussion in lesson 2. Check your understanding of the

topics by answering the 30-item short quiz in the learning management
system (LMS) of this course. Feedback will be given after the
examination is closed.
Good luck!

Chronic) | 29
References:
Boyd, M. (2008). Psychiatric Nursing: Contemporary Practice, 4th edition. Philadelphia PA:
Wolters Kluwer.
Cherry, K. (2020). Neurons and their role in the nervous system. Verywell Mind.
https://www.verywellmind.com/what-is-a-neuron-2794890
Cherry, K. (2020). Studying the brain and behavior in biopsychology. Verywell Mind.
https://www.verywellmind.com/what-is-biopsychology-2794883
Fatima, Maheen (2019). Types of human behavior in psychology.

Bioscience.https://www.bioscience.com.pk/topics/psychology/item/1311-types-of-
human-behavior-in-psychology
Farnsworth, Bryn (2019). Human behavior: The complete pocket guide. Imoticons.
https://imotions.com/blog/human-behavior/
Townsend, M.C. (2011) Essentials of Psychiatric Mental Health Nursing: Concept of care in
evidence-based practice, 5th edition. Philadelphia PA: F.A. Davis Company.
Videbeck, S.L. (2020). Psychiatric-Mental Health Nursing, 8th edition. Philadelphia PA:
Wolters Kluwer.
https://www.learningonthemove.org/learning--memory.html
https://www.psychologistanywhereanytime.com/emotional_problems_psychologist/pyscho
logist_frustration.htm
https://www.slideshare.net/JohnykuttyJoseph/unit-4-frustartion-conflicts-and-stress
https://courses.lumenlearning.com/boundless-psychology/chapter/theories-of-
motivation/#:~:text=Motivation%20describes%20the%20wants%20or,by%20social%20
and%20psychological%20mechanisms.

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Instructional Module in NCM 117a (Care of Clients with Maladaptive Patterns of Behavior, Acute and

CHAPTER I. CONCEPTS OF MENTAL HEALTH AND MENTAL ILLNESS

LESSON 2: PSYCHOBIOLOGIC BASES OF BEHAVIOR

INTRODUCTION OF THE LESSON

Psychobiology is a branch of psychology that analyzes how the brain,

LEARNING OUTCOMES FOR THIS LESSON

At the end of this lesson, you must have:

1. Described neurons as to components, functions, and types;

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

WARM-UP ACTIVITY. Based on your previous knowledge, how

Neuro-anatomy and Neurophysiology

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

Figure 1.1. Basic components of a neuron.

Photo credit: Science Photo Library - KTSDESIGN/Getty Images

The Central Nervous System (CNS)

Figure 1.2. Anatomy of the brain.

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

Figure 1.3. The brain and its structures.

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

Memory, Repetition and Learning Neurotransmitters

Learning is an electrical and chemical connection made between neurons in our

Neurotransmitters are the chemical substances that aid in the transmission of

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

Figure 1.4. Schematic illustration of (1) neurotransmitter (T) release; (2)

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

Dopamine - Arise from the Involved in the regulation Decreased levels of

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

Glutamate - Found in the pyramidal Functions in the relay of Increased receptor

Somatostatin -also Found in the cerebral As a neurotransmitter, it High concentrations

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

ACTIVITY 1. Based on what you have learned so far, briefly explain

Concepts and Patterns of Human Behavior

Learning input 2 presents the fundamental concepts needed to understand human

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

Functional Family. In a functional family, parents strive to create an environment

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

While random behavior is not purposive and is not functional or adaptive

Instincts. Instincts differ from reflexes primarily in their greater degree of

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

The method of acquiring habits is that known as the conditioning of

Concepts of Human Behavior

In scientific research, human behavior is viewed as a complex interplay of three

Emotions are behavior. An emotion is any relatively brief conscious experience

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

 Molecular and Moral Behavior

Overt Behavior: It is a visible type of behavior that can occur outside of

 Voluntary and Involuntary Behavior

Voluntary Behavior: It is a type of behavior that depends on human want. We

Involuntary Behavior: Unlike voluntary behavior, this type occurs naturally

Concepts of Mental Health and Mental Illness

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

Also, Townsend (2011) defines mental health as “the successful adaptation to

Videbeck (2014) refutes however, that there is no single universal definition of

Mental Illness. As mentioned earlier, a universal concept of mental illness is difficult

Horwitz (2002 as cited in Townsend, 2011), identifies two of these elements as

Mental disorders often cause significant distress or impaired functioning or both.

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

Maslow formulated the hierarchy of needs, in which he used a pyramid to arrange

Frustrations. One major element of maladjustment that is consistently repeated in

Chapter 1 Lesson 2: Psychobiologic Bases of Behavior

Internal sources of frustration usually involve physical abnormality or defects, conflicting