2. Gottesman (2010) Flashcards
Aim?
Method/ where did the data come from?
Sample?
Variables?
Aim
To investigate the likelihood of offspring developing schizophrenia, bipolar disorder or another disorder if one or both parents have been diagnosed with one of these mental illnesses.
Method
Cohort study using secondary data from Danish Civil Registration and Danish Psychiatric Register using a natural experiment
Sample
2.7 million born in ’68 and offspring 10 years or older in 2007
Variables
Independent variable:
- Parental sz or bipolar.
- Operationalised as diagnosis is from ICD.
Dependent variable:
- Diagnosis of any mental illness.
- Also operationalised as diagnosis is from ICD
Results
- Chances of getting SZ if both parents have it?
- Chances of any disorder if both parents have SZ?
- Chances if 1 parent has it?
1. Chances of getting SZ if both parents have it?
27.3%
2. Chances of any disorder if both parents have SZ?
67.5%
3. Chances of getting Sz if 1 parent has it?
7%
Validity (3)
- Uses the ICD to diagnose the disorders so based on a valid measurement
- However there could be differential diagnosis issues – overlapping of symptoms so patients could be mis-diagnosed
- Cannot ignore the impact of the environment as this could also play a factor e.g. SZ environment
Sampling bias (2)
- A huge sample of 2.7 million people was obtained, which included a wide range of individuals from Denmark so high in population validity and results would be representative of people of different classes and socio-economic statuses.
- However, results could not be generalised to different cultures, as other factors may be more important in other countries.
Reliability (2)
- There is a consistent pattern that emerges for both schizophrenia and bipolar disorder in relation to the likelihood of admittance for either disorder increasing if one or (even more so) both parents were themselves admitted with the disorder.
- The fact that two disorders were studied (rather than one)
Ethnocentric(2)
- Based on Western culture, often linked to a biological and genetic basis, however other cultures might see mental health in a different light.
- Also Denmark have a more positive attitude to mental health so it might be easier to diagnose.
Ethical considerations (1)
- The study was approved by the Danish Data Protection Agency. Because data were available for register-based research and did not include information that could lead to the identification of individuals, approval from the National Scientific Ethical Committee was not required. Therefore all data were anonymous and confidential, and informed consent from individuals was not required.
Socially Sensitive (3)
- It suggests that two individuals with a mental illness should carefully consider whether to have children due to the high chance of passing on the disorder; this is therefore socially sensitive research.
- This can also lead to genetic counsellors advising people not to have children or even insurance rates such as life insurance to increase for certain groups
- This could also encourage a eugenics argument that certain people should not be allowed to reproduce to prevent damage to the human gene pool.
Biological determinism (1)
- Gottesman et al. concluded that individuals who have two parents with the same mental disorder have a ‘super high’ risk of developing the disorder themselves.
Gottesman’s view is biologically determined in that mental illness will be passed on through our genes.
Nature/nurture (2)
- In Gottesman’s research he showed that children with two parents who had been admitted to hospital with a diagnosis of schizophrenia were much more likely to be diagnosed themselves with schizophrenia and even bipolar, showing genetic similarities between these two disorders.
- However more likely it is the diathesis-stress model that is at play – genes (nature) are triggered by an event (nurture) as CR are not 100%
Usefulness
- Can be useful for genetic counsellors to advise parents with mental health issues to decide whether to have children or not
However the implications can also be large – what about:
- Eugenics – some may use this as evidence that people with mental health disorders should not have children as this can ‘damage’ the human gene pool
- insurance rates – it may cost more to insure yourself through health/life insurance if your parents have mental health disorders
- social workers intervention – this may mean that social workers etc, are more involved in your family life
Explain how the key research by Gottesman (2010) contributes to an understanding of individual, social and cultural diversity.
Individual diversity
How it affects the person
- Concordance rates are not 100% so genes do not equal mental health issues
Social diversity
How it affects society and social groups
- Some people are more susceptible to being diagnosed with mental health issues than others – linked to social class. The lower social classes are more susceptible to labelling and stigma.
- This can link also to socially sensitive issues with genetic counsellors, it may stop some people from having babies
Cultural diversity
How it is linked to culture
- Denmark uses the ICD rather than the DSM, it was also based on 2 versions of the ICD -8 and 10
- Cultural attitudes are different towards mental health, in Denmark there is less stigma attached to mental health issues and much easier to diagnose
