Component 3: Issues In Mental Health - Historical Context Flashcards
What is the supernatural explanation for mental illness and what is the treatment?
Mental illness was though to be due to witchcraft, religion and demonic possession. It was a punishment for wrongdoing.
Treated by saying prayers, immersing in holy water or ‘doing good deeds.’ They alos carried out exorcisms which involved trephining, stretching, starving etc. to make the evil spirit uncomfortable so it would leave.
What is the humoural theory explaination and how was it treated?
Hippocrates, a Greek physician, believed mental illness was caused by an imbalance of four types of body fluids called humours. These were blood, phlegm, yellow bile and black bile which related to different aspects of the personality.
Hippocrates suggested rebalancing the humours to relieve symptoms. This included purging and bloodletting (using leaches to suck blood)
What is the psychogenic explaination and how was it treated?
This attributes mental illness to psychological factors. Freud theorised that mental illness was a result of unresolved unconcious conflicts which impacted behaviour.
Treatments inlcluded psychoanalysis such as free association and dream analysis. This has led to other forms of talking therapy such as cognitive behavioural therapy.
What is the medical model and what are the treatments?
The 20th centuray onwards has seen a return to physical explainations. Mental illness is seen to be largely due to imbalances and abnormal levels of neurotransmitters as well as brain abnormalities and inherited genes.
Treatments include drug therapies, electro-convulsive therapy and psychosurgery (e.g lobotomy).
Abnormality: What is statistical infrequency and what are the strengths and weaknesses?
Under the definition of abnormality, a person is considered abnormal if their behavior/thinking is statistically infreuqent. This means it needs to be in the bottom 2% of the population.
Strengths: it helps to make cut off points in terms of diagnosis
Weaknesses:
- fails to distinguish between desirable and undesirable behaviour
-many rare behaviours have no bearing to abnormality (e.g. left handed-ness) some some characteristics are considered abnormal despite being statistically frequent (depression 27% of elderly people) Just because it is common doesn’t mean it isn’t a problem.
-who decides what is statistically rare and how do they decide?
Abnormality: What are deviations from social norms and what are the weaknesses?
A person’s thinking or behviour is considered abnormal if it violates the (unwritten) rules anout what is expected or acceptable behaviour in a particular social group. The bhaviour may make others feel uncomfortable or threatened.
Weaknesses:
- there is no universal agreement over social norms
-social norms are culturally specific and they can significantlt differ from one generation to the next
-social norms also exist within a time frame. Behaviour that was once seen as abnormal may become acceptable and vice versa.
Abnormality: What is maladaptiveness and what are the weaknesses?
A person is considered abnormal if they are unable to cope with the demands of everyday life. They may be unable to perform the behaviours necessary for day-to0day living. E.g. self-care, holding down a job
Weaknesses:
-abnormal behaviour may seem helpful, functional or adaptive for an indiviudal. E.g. someone with ocd may feel compelled to handwash and this may make them feel happier/able to cope with their day.
-many people engage in behaviour that is maladaptive/harmful but we don’t class them as abnormal. E.g. adrenaline sports, smoking, drinking alcohol, skipping classes
What is the DSM?
Diagnostic and Statistical Manual of Mental Disorders, produced by thr American Psychiatric Association and used exclusively in America. Over different editions, there have been many changes. E.g. homesexuality was considered a mental disorder in the first edition but this was changed in the second edition.
Section 1 introduces the new DSM
Section 2 introduces 20 categories of disorders, many come with a spectrum of severity
Section 3 provides assessment tools, discusses cultural concepts and icludes disorders that appear to exist but require more research.
What is the ICD?
International Statustical Classification of Diseases and Related Health Problems.
Produced by the World Health Organisation and is used internationally.
It classifies both physical and mental health conditions.
It is used to study disease patterns, as well as clinical care to minitor outcomes and allocate resources.
There are 21 chapters, each with sevral subcategories. Chapter 5 relates to mental disorders and there are 11 subcategories within it.
How is mental illness diagnosed?
There are no physical symptoms so a clinician must rely on the self-report of the patient or those that know the patient to make the diagnosis. Once symptoms are gathered, the clinican can use the diagnostic manuals to find a diagnosis. This is then used to suggest a suitable treatment.
What is the background to Rosenhan’s research?
Psychiatrists started to criticise the medical model in the 1960s. This was known as the anti-psychiatry movement that Rosenhan was apart of.He hypothesised that diagnosis was not related to the characteristics of the patient but the context in which the diagnosis was made and the use of the classification systems was unreliable and invalid.
What was the aim of Rosenhan’s research?
To test the validity and reliability of psychiatric diagnosis
What was the research method of Rosenhan’s study?
- Field experiment (IV- made up symptoms of the psuedo-patients, DV- psychiatrist’s admission and diagnostic label)
- study also involved participant observation (psuedo-patients kept written records of how the ward operated)
Who were the sample in Rosenhan’s study?
8 sane people attempted to gain admission to 12 different hospitals in 5 different states in the USA.
What was the procedure of Rosenhan’s study?
- Psuedo=patients made an appointment at the hospital and complain about hearing voices. It said ‘empty’ ‘hollow’ and ‘thud’. These were chosen as they were like existential symptoms which has no mention in psychiatric literature.
- Patients gave a false name and job but other details were true.
- After being admitted, psuedo-patients stopped simulating any symptoms
- They took part in ward activities and when asked how they felt, said they no longer experienced symptoms.
- In 4 of the hospitals, patients carried out an observation of staff’s behaviour towards patients to illustrate experience of being hospitalised.
- They would approach staff to ask simple questions but they were treated like they were invisible.
