Chapter 1: Mental Health and Mental Illness \ Chapter 1 on Mental
Health and Mental Illness, defines health as effective functioning,
resilience, and coping, while illness involves diagnosable, distressing
disorders affecting thinking and behavior. Exam topics focus on defining
mental health/illness, identifying warning signs, understanding the mental
health continuum, and recognizing core concepts of psychiatric nursing
care.
Key Topics Covered:
Definitions: Distinguishing between mental health
(well-being/productivity) and mental illness (significant impairment).
Key Attributes: Traits of mental health including resilience, emotional
regulation, and social functioning.
Diagnostic Tools: Overview of tools used for diagnosis such as the
Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).
Warning Signs: Identifying prodromal symptoms like extreme mood
swings, social withdrawal, and high anxiety.
Epidemiology: Basic understanding of incidence and prevalence of
disorders.
Stigma and Culture: The impact of stigma on seeking treatment and
cultural considerations in defining health.
Concepts of Care: Introduction to nursing care, including evidence-based
practice and safety.
This chapter sets the foundation for understanding the spectrum of human
behavior from functional to dysfunctional.
(Ultimate Guide for Yr. 2026/2027)
● Mental Health
○ 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
○ Goal: Self-actualization (Maslow's)
● Mental Illness
○ Maladaptive responses to stressors
○ Thoughts, feelings, behaviors incongruent with cultural norms
○ Interferes with social, occupational, or physical functioning
● Incomprehensibility
○ Behavior doesn’t make sense to others
,● Cultural relativity
○ “Normal” depends on culture
● Horwitz’s Adaptation Syndrome eaction
General
stage
○ Alarm r ■
The initial response to a stressor
● E.g. narrowly avoiding a car accident, having a pounding heart, sweaty
palms, increased respirations
■ Stage of resistance
● Body attempts to adapt to stressor
■ Stage of exhaustion
● Resources are depleted and the body can no longer resist stress
● Responses to Fight-or-Flight
○ Immediate response: acute physiological changes seen in the alarm stage
○ Sustained response: occurs after prolonged stress and can increase susceptibility to
disease
○ Occurs in response to psychological or emotional stimuli
■ Not resolved as rapidly as some physical stressors
■ Modern stress
● Pervasive, chronic, relentless
■ Anxiety and grief
● Adaptation depends on the extent to which thoughts, feelings, and
behaviors interfere with an individual’s functioning
● Anxiety
○ A feeling of discomfort and apprehension related to fear of impending danger
○ Common and can be adaptive at mild levels, providing motivation for survival.
● Paplau’s Four Levels of Anxiety
○ Mild anxiety
■ Can enhance perception/learning
■ Individuals employ coping mechanisms to deal with stress
● Eating, drinking, sleeping, exercise
, ○ Moderate
■ Perceptual field begins to diminish
■ Ego defense mechanisms are employed for protection
○ Severe
■ Perceptual field diminishes greatly, focus is on small or scattered details
○ Panic
■ Most intense; unable to focus or learn; may experience delusions
● Defens e Mechanisms
○ Compensation
■ Overachievement in one area to make up for deficiency in another
○ Denial
■ Refusing to acknowledge an unacceptable reality
○ Displacement
■ Transferring feelings from one object or person to another less threatening one
○ Identification
■ Unconsciously imitating the behavior of someone perceived to be admired
○ Intellectualization
■ Focusing on the intellectual aspects of a situation to avoid emotional distress
○ Introjection
■ Internalizing the beliefs and values of another person
○ Isolation
■ Separating a thought or memory from the emotion connected to it.
○ Projection
■ Attributing one’s own unacceptable thoughts, feelings, or impulses to another
person
○ Rationalization
■ Creating logical excuses for unacceptable behavior or feelings
○ Reaction formation
■ Acting opposite to how one truly feels to prevent unacceptable feelings from
being expressed
○ Regression
■ Reverting to an earlier developmental level of behavior
, ○ Repression
■ Unconsciously blocking unacceptable thoughts or feelings from consciousness
○ Sublimation
■ Channeling unacceptable impulses into socially acceptable activities
○ Suppression
■ Consciously blocking disturbing thoughts or feelings from awareness
○ Undoing
■ Performing an action to counteract a previous unacceptable action or thought
● Conseuences of Unresolved Anxiety
q Moderate to severe
○
■ Can contribute to physiological disorders
○ Severe
■ Extended periods of repressed severe anxiety can lead to psychoneurotic patterns
● Neurosis: a psychiatric disturbance with excessive anxiety, either
expressed directly or altered through defense mechanisms.
● Impairs functioning but w/o gross distortion of reality
○ Panic
■ Extended periods may result in psychosis
● Schizophrenia, schizoaffective disorder, and delusional disorder
● Grief
● Stages
○ Denial
○ Anger
○ Bargaining
○ Depression
○ Acceptance
Health and Mental Illness, defines health as effective functioning,
resilience, and coping, while illness involves diagnosable, distressing
disorders affecting thinking and behavior. Exam topics focus on defining
mental health/illness, identifying warning signs, understanding the mental
health continuum, and recognizing core concepts of psychiatric nursing
care.
Key Topics Covered:
Definitions: Distinguishing between mental health
(well-being/productivity) and mental illness (significant impairment).
Key Attributes: Traits of mental health including resilience, emotional
regulation, and social functioning.
Diagnostic Tools: Overview of tools used for diagnosis such as the
Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).
Warning Signs: Identifying prodromal symptoms like extreme mood
swings, social withdrawal, and high anxiety.
Epidemiology: Basic understanding of incidence and prevalence of
disorders.
Stigma and Culture: The impact of stigma on seeking treatment and
cultural considerations in defining health.
Concepts of Care: Introduction to nursing care, including evidence-based
practice and safety.
This chapter sets the foundation for understanding the spectrum of human
behavior from functional to dysfunctional.
(Ultimate Guide for Yr. 2026/2027)
● Mental Health
○ 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
○ Goal: Self-actualization (Maslow's)
● Mental Illness
○ Maladaptive responses to stressors
○ Thoughts, feelings, behaviors incongruent with cultural norms
○ Interferes with social, occupational, or physical functioning
● Incomprehensibility
○ Behavior doesn’t make sense to others
,● Cultural relativity
○ “Normal” depends on culture
● Horwitz’s Adaptation Syndrome eaction
General
stage
○ Alarm r ■
The initial response to a stressor
● E.g. narrowly avoiding a car accident, having a pounding heart, sweaty
palms, increased respirations
■ Stage of resistance
● Body attempts to adapt to stressor
■ Stage of exhaustion
● Resources are depleted and the body can no longer resist stress
● Responses to Fight-or-Flight
○ Immediate response: acute physiological changes seen in the alarm stage
○ Sustained response: occurs after prolonged stress and can increase susceptibility to
disease
○ Occurs in response to psychological or emotional stimuli
■ Not resolved as rapidly as some physical stressors
■ Modern stress
● Pervasive, chronic, relentless
■ Anxiety and grief
● Adaptation depends on the extent to which thoughts, feelings, and
behaviors interfere with an individual’s functioning
● Anxiety
○ A feeling of discomfort and apprehension related to fear of impending danger
○ Common and can be adaptive at mild levels, providing motivation for survival.
● Paplau’s Four Levels of Anxiety
○ Mild anxiety
■ Can enhance perception/learning
■ Individuals employ coping mechanisms to deal with stress
● Eating, drinking, sleeping, exercise
, ○ Moderate
■ Perceptual field begins to diminish
■ Ego defense mechanisms are employed for protection
○ Severe
■ Perceptual field diminishes greatly, focus is on small or scattered details
○ Panic
■ Most intense; unable to focus or learn; may experience delusions
● Defens e Mechanisms
○ Compensation
■ Overachievement in one area to make up for deficiency in another
○ Denial
■ Refusing to acknowledge an unacceptable reality
○ Displacement
■ Transferring feelings from one object or person to another less threatening one
○ Identification
■ Unconsciously imitating the behavior of someone perceived to be admired
○ Intellectualization
■ Focusing on the intellectual aspects of a situation to avoid emotional distress
○ Introjection
■ Internalizing the beliefs and values of another person
○ Isolation
■ Separating a thought or memory from the emotion connected to it.
○ Projection
■ Attributing one’s own unacceptable thoughts, feelings, or impulses to another
person
○ Rationalization
■ Creating logical excuses for unacceptable behavior or feelings
○ Reaction formation
■ Acting opposite to how one truly feels to prevent unacceptable feelings from
being expressed
○ Regression
■ Reverting to an earlier developmental level of behavior
, ○ Repression
■ Unconsciously blocking unacceptable thoughts or feelings from consciousness
○ Sublimation
■ Channeling unacceptable impulses into socially acceptable activities
○ Suppression
■ Consciously blocking disturbing thoughts or feelings from awareness
○ Undoing
■ Performing an action to counteract a previous unacceptable action or thought
● Conseuences of Unresolved Anxiety
q Moderate to severe
○
■ Can contribute to physiological disorders
○ Severe
■ Extended periods of repressed severe anxiety can lead to psychoneurotic patterns
● Neurosis: a psychiatric disturbance with excessive anxiety, either
expressed directly or altered through defense mechanisms.
● Impairs functioning but w/o gross distortion of reality
○ Panic
■ Extended periods may result in psychosis
● Schizophrenia, schizoaffective disorder, and delusional disorder
● Grief
● Stages
○ Denial
○ Anger
○ Bargaining
○ Depression
○ Acceptance
