Alternative to the Medical Model

Question 1

What is the behaviourist explanation of mental illness (classical conditioning) and what research can be used to support this?

Answer 1

Classical conditioning happens when an emotional response such as fear becomes associated with a neutral stimulus.

Pavlov (1903)
Watson and Rayner (1920)

Question 2

Outline Pavlovs reserach on classical condiitoning

Answer 2

He taught dogs to salivate when they heard a bell that they had come to associated with the presentation of food.

Question 3

Outline Watson and Rayer’s reserach on classical conditioning

Answer 3

Case study on Little Albert.

The experimenters presented a white rat to Little Albert and then struck a hammer against a metal bar to induce fear. This producer was repeated.

Little Albert formed a fear of rats and other similar animals.

Question 4

How does classical conditioning lead to mental disorders?

Answer 4

People may develop hydrophobia (fear of water or drowning) as a result of falling into water (neutral stimulus) at a young age, not being able to swim and being submerged (unconditional response of fear/panic) and developing a powerful life long fear of water (conditional response).

Question 5

What is the behaviourist explanation of mental illness

(operant conditioning) and what research can be used to support this?

Answer 5

When behaviour is reinforced, that behaviour becomes more likely to be repeated.

Skinner (1948)

Question 6

Outline the difference between positive and negative reinforcement

Answer 6

Positive reinforcement strengthens a behaviour by providing a consequence an individual finds rewarding.

Negative reinforcement is the removal of an stimulus which is ‘rewarding’ to the animal or person. Negative reinforcement strengthens behaviour because it stops or removes an unpleasant experience.

Question 7

Outline research by Skinner (1948) on operant conditioning

Answer 7

Skinner conducted research on rats.

Study 1: rats were not fed and grew hungry, in the cage in which they were placed there was a lever that when pressed released food. Rats though positive reinforcement learnt to press the lever when hungry. Positive reinforcement.

Study 2: rats were put in the cage, the floor of the cage generated electric shocks which caused pain for the rat. If the rat pressed the leaver the shocks would stop. Negative reinforcement.

Question 8

How can operant conditioning lead to a mental illness?

Answer 8

. If someone tries gambling and has some success, their behaviour is reinforced.

A schedule of reinforcement is the set of rules for giving rewards.

Question 9

What is the cognitive explanation of mental illness?

Answer 9

The cognitive explanation considers thinking, attention and perception that underlie abnormal behaviour.

It explains symptoms and causes of mental disorder though examining irrational or maladaptive beliefs.

Question 10

What are examples of cognitive distortions?

Answer 10

Over-generalisation (one event as part of a never ending defeat or struggle)

Filtering (only focus on negative aspects)

Catastohisation (far worse than it actually is)

Dichotomous reasoning (all or nothing)

Question 11

How does Beck (1967) support the cogitative explanation of mental illness

Answer 11

Interviews were held with 50 depressed patients to find out their thoughts and get them to start diaries.

The study uncovered how the patients have cognitive distortions which change their logical and view of realism.

The distortions appeared to be uncontrollable, as if they automatically had the thoughts without being aware

Question 12

What is CBT?

Answer 12

Cognitive-behavioural therapy for depression

Takes place once a week for 5 to 20 sessions.
Patient identifying irrational and unhelpful thoughts and trying to change them.

It aims to:
To re-establish previous levels of activity
To re-establish a social life
To challenge patterns of negative thinking
To learn to spot the early signs of recurring depression

Question 13

What is the humanistic exploitation of mental illness?

Answer 13

The humanistic perspective aims to understand human nature using simple principles and a minimum of theory, through emphasising the study of the whole person.

Question 14

What is Maslows hierarchy of needs?

Answer 14

Maslow’s hierarchy of needs is a motivational theory made up of 5 tiers of human needs.

Once that level is fulfilled you begin to focus on the next level up
The level you are on is often based on your environment

Question 15

What is Carl Rogers theory about the humanistic exlanation?

Answer 15

He proposed that understanding healthy psychological development depends on: the actualising tendency and self concept.

Question 16

What is self actualisation

Answer 16

You are not constrained by your environment and you seek to reach your goals, by doing this you are at the top of Maslow’s Pyramid.

Rogers believed that humans are primarily motivated by the need to actualise: seeking fulfilment and change through personal growth self-fulfilment

Question 17

What is self concept?

Answer 17

Rogers believed that we hold an image of our self and how we wish to be. If your self and your self image is the same well will experience high self esteem.

Self-concept depends on our receiving of unconditional positive regard (in the form of love, affection and acceptance, this could be given by friends or family).

Question 18

How does the humanistic explanation explain depression?

Answer 18

Some children lack positive regard as children resulting in low self esteem in later life meaning they are venerable to disorders.

Question 19

How is humanistic theory used to treat depression?

Answer 19

Rejects diagnosing mental disorders.

Refers to patients as clients.

They encourage client to focus on their feelings and let the client take the lead.
The main focus is present and future and not the past.

Rogers suggested 3 core-conditions, which help clients in their personal growth:

Empathy: the ability to understand what the client is feeling.

Congruence (genuineness): allows clients to experience them as they really are.

Unconditional positive regard: important for the clients to value themselves and have good self-esteem.

Question 20

What was the research method used in Szasz research?

Answer 20

An article which critiques changes in the beliefs and concepts surrounding mental health and changes in mental healthcare in the USA over fifty years since 1960.

Question 21

What did Szasz say about 1950s mental healthcare?

Answer 21

Mental patients were considered incurable and confined in mental hospitals.

The physicians who cared for them were employees of the state governments.

Question 22

What did Szasz say about current day mental healthcare

Answer 22

Mental health professionals are legally responsible for preventing her patients from being ‘dangerous to herself or others’

Psychiatry is medicalised and politicised

Question 23

Define medicalisation

Answer 23

Categorisation or treatment of behaviour/event as a medical problem (even if unjustified).

Question 24

Define politicisation

Answer 24

To make a phenomenon, such as mental illness, political in nature. (Politicians wield power then over the individual through policy).

Question 25

What did szasz claim about mental illness as a medical or legal concept?

Answer 25

The claim that mental illnesses are diagnosable disorders of the brain is not based on scientific research.

Diagnosis rests on the person’s definition of illness therefore mental illness is a metaphor.

Szasz claims that mental hospitals are more like prisons and that involuntary

Question 26

Outline szasz point of mental illness is in the eye of the beholder?

Answer 26

Mental diseases are the medicalisation of disturbed behaviours.

individuals diagnosed as mentally ill are deprived of their liberty and responsibility.

Psychiatric practice rests on the idea that the patient may be a danger to himself or others and the moral and professional duty of the psychiatrist is to protect the patient from himself and society from the patient.

Question 27

What did Szasz conclude?

Answer 27

1. Psychiatry is a pseudoscience
2. Mental illness is a myth
3. Mental illness is now considered a legal and no longer medical concept
4. The old religious-humanistic perspective on the tragic nature of life has been replaced with a modern, dehumanised, pseudo medical one
5. Mental illness is in the eye of the beholder
6. It is wrong to treat individuals, labelled as mentally ill, as sick patients needing psychiatric treatment, regardless of whether they seek or reject such help
7. Over the past fifty years, psychiatry has become thoroughly medicalised and politicised
8. There are alternatives to the medical model as explanations for mental illness