2 - Overview and History

Question 1

What is the 4 D’s?

and explain each

Answer 1

1. deviance; deviant from society’s established norms
2. distress; through context, excessive emotional/physical distress hindering basic living
3. dysfunction; assessed through daily/basic functioning: physical mobility, feeding, dressing and hygiene and instrumental functioning
4. danger

Question 2

the 4 D’s

Danger

relative risks and the stats

Answer 2

• ; depends on the condition, severity, treatment status
• relative risk (odds ratio): 3:1; risk increases with illness severity
• without external risks (substance abuse, history with violence etc.) relative risk is ~1:1; condition itself is not always the only cause
• population attributable risk of violence from mental illness is ~4%
• relative risk for suicide is ~12:1 (women is higher but men are more likely to die)
• there is an increase in interpersonal stigma; discrimination, reduction in social contacts, punishment

Question 3

Philosophy of Science

explain paradigms and how they progress over time

draw the graph

Answer 3

• Kuhn: models/ paradigms emerge during periods of crisis when important phenomena cannot be resolved by the pre-existing paradigm
• fundamentally social process: society defines an important problem
• becomes the norm when people accept the new paradigm

Question 4

Philosphy of Science

what is a model?

Answer 4

• simplified description of reality
• must generalize to many specific instances of a phenomenon
• must work universally
• eg. a map
• may models are used to understand psychopathology but mental health lacs a central consensus paradigm to guide it

Question 5

Philosophy of History

define: underdetermination, overdetermination, fallacy of the single cause

in the context of historical events

Answer 5

• underdetermination: the available evidence fails to provide sufficient explanation for why something happened
• overdetermination: multiple possible causes exist for the event, each one has a sufficient explanation; unable to find the real cause
• fallacy of the single cause: the assumption that events have a single, simple cause

Question 6

Philosphy of history

what are the 3 different framworks for understanding and doing history

Answer 6

1. “Great man” theory: history can be explained by the action/ influence of extraordinary individuals
2. “historical materalism” (Marxism): history is the result of socioeconomic forces
3. contingency: history sis thr product of randomness and chance

Question 7

History of Mental Health

Explain the ancient practices

Answer 7

• ancient societies did often care for the people who were injured and even with mental illness; eg. trepanation/trepanning
• seems like the goals was to treat the patient and provide them with care post-surgery
• understood a relationship b/w the head/brain and psychology/behaviour - biological model
• some surgeries have been preformed with cermonial figures - supernatural model
• Hippocrates: define illness in terms of natural/physical causes

Question 8

Philosophy of History

Explain the middle ages

Answer 8

• naturalistic/empirical models of the Greeks and Romans never dominated mass society
• mental illness might be attributed to possession, bodily dysfunction or negative life experiences; treatment could be spiritual,herbal/medical,social

Question 9

Philosophy of History

Explain early modern practices

asylums and practices in England

Answer 9

• rise of asylums; eclectic practices largely ended
• first recognizable versions emerged in 14th Century Spain
• asylums were adopted quickly across Europe and America which endured for centuries; the dominant model
• England: patients were in workhouses; idea that morality (work is morally good) was recovered by being productive
• but compared to workhouses, asylums were considered more humane

Question 10

Philosophy of History

Explain the modern era

and deinstitutionalization of asylums

Answer 10

• 19th century: new models arise based on developments in medicine, philosphy, science, and sociolgy
• although asylums continued to exist till the late 20th century
• asylums vanish due to: more effective pharmaceuticals, cost (expensive to maintain) and it would be easier for community care
• although not everyone support that change