Gavin MHI 1

Question 1

Stats on increasing MHI

Answer 1

2007: 1/4 adults 16-74, in 2014 half were accessing treatment. In2010: public donates 500 mill to cancer research, less for MH (most is Alzheimer’s)

Question 2

biological supernatural approach

Answer 2

Stone age/ neolithic 3000BC skulls show trepanning to get rid of mental health disorders by letting out the evil spirits- selling 1940, some were done many times, some larger, some had survived and healed (survival was 40%). Mhi due to displeasure of gods/demons. Possession of spirits - exorcism

Question 3

Classic Antiquity: Naturalistic approach

Answer 3

Hippocrates 460-377bc. MH had natural causes like imbalance of humours e.g. excess black led to depression so need sobriety, no sex, care over food . Born in kos believed medicine should be scientific discipline, holistic (drugs, diet, exercise) mental and physical related/ healthy mind healthy body, healing the soul via music. Brain organ of consciousness, monks prayed over them

Question 4

Emperor marcus aurelius: 161-180 AD

Answer 4

Stoicism, cooed W stress of running Roman Empire, kept notebook for + thoughts (meditation), everything is an opinion not a fact (like cbt)

Question 5

Galen 129-216 AD

Answer 5

Physician to gladiators and Aurelius. Distinguished between physical and mental disorders like brain injury and emotional stressors. Wrote on the passions and errors of the soul, had talk therapy

Question 6

Middle ages: 578AD: Europe more focused on the supernatural

Answer 6

Bethlam hospital: housing for poor and sick in 1247 Boswell ‘the life of dr johnsn’: went as entertainment
Jane Eyre in Charlotte bronte: the lunatic is both cunning and malignant, she has never failed to take advantage of her guardians temporary lapses, once to secrete the knife with which she stabbed her brother.

Question 7

Cultural and scientific renaissance 14th-16th C:

Answer 7

Gutenburg 1440:printing press, enabled dissemination of knowledge on a scale never seen.
Copernicus/Galileo 1610: moon orbiting jupiter but persecuted as said didn’t all orbit earth.
Newton:1687 individual liberty and religious tolerance,

Question 8

Asylums

Answer 8

Pinel (father of modern psychiatry) established better conditions, moral management, seen in a painting, reserved for mainly upper class . York retreat: Hannah mills the Quaker admitted and died there so quakers develop better alternatives (York retreat 1796). Bethlam wakefield another Quaker inspected and saw p James norries who was restrained forever , House of Commons did reforms. Hired other doctor who did sport, music, food and clothes

Question 9

Examples of bad treatment in asylums

Answer 9

Elizabeth: done for infantacide and epileptic fits, stayed for 10 years then released. Sarah gardener: worthlessness, stigma about working for a man in the home and festered by fiancé, after 2 months was discharged and recovered. Emma riches: PnatalD, out in strong dress (can’t be torn), wouldn’t eat but symptoms passed 1 year, Daniel mcnaighten: Manama and homocide due to delusions (insanity defence), John Payne: ruffianism and homocide, NGRI, after mental hospital took up a trade and cared by sister

Question 10

Old treatments

Answer 10

The swing: rush 1772, madness due to inflammation of brain, reduced attention to world, tranq chair (reduced sensory input), wet packs (for schizo, could use water baths for hours), insulin shock therapy (given in bigger doses 6/week until coma- sakel, ECT (induce seizure, reduced some depression, no numbing, overused), full frontal lobotomy (moniz broke connection thalamus and frontal, unconscious via ECT, deaths and deficits

Question 11

Current approaches to defining mental disorders: general criteria and weaknesses

Answer 11

Statistical infrequency, violation of social norms, personal distress, disability, harmful dysfunction. Wakefield 1992, has limitations like socially constructed and there’s exceptions

Question 12

First know classification by Hippocrates

Answer 12

mania, melancholy, phrenitis, insanity, disobedience, paranoia, panic, epilepsy, hysteria. Need to be handled like physical, sensitivity reached the brain through breathing

Question 13

The dsm and weaknesses

Answer 13

In ‘52 had 106, dsm 5 has 400 in 2013, more continuous and more valued research. Mezzich- expensive, cultural bias (medicalisation) e.g. Dexedrine/amp sold to tired women, ties to the drug industry and dsm

Question 14

Icd

Answer 14

Took over by WHO before it was physical, 2022 has hundreds. S: more simple, free W: more qualitative and general, lacks new stuff like BDD

Question 15

BPS

Answer 15

30% are disorders not otherwise specified, reliability issues when diagnosing freedman 2013, culturally dependent as had homo till 1994, drapetomania for slaves wanting to run away

Question 16

3 characteristics of any diagnosis

Answer 16

Personal distress tho not all (antisocial don’t feel guilt, not all stress is a disorder like grief), disability and dysfunction (impairment in area of life, not all like bulimia, being blind not included, developmental, physiological and biological dysfunctions), violation of social norms (too broad as criminals break and anxious ppl don’t, vary across culture)

Question 17

Lunacy trials

Answer 17

From 13th c on, hospitals were secular, mad safe until restored to reason. Trials to determine MH, crown became guardian of estate, memory, habits examined. Strange behaviour due to physical illness or injury, demonic possession, term lunacy from Paracelsus misalignment W moon and stars

Question 18

Origin of asylums

Answer 18

Until 15th c few and many for leprosy, as it decreased they were converted,. Viewing bedlam options aas entertainment, rush: express boood in the brain, cured by being frightened,

Question 19

Old bio approaches to MI

Answer 19

Syphilis caused worse mental and physical health, given name paresis. 1860s, pasture created germ theory and 1905 microorganism for syphilis discoursed. Galton study of twins said behaviour hereditary and created eugenics movement , Mesmer: ppl had hysteria and some physical effect s, caused by magnetic fluid in body, used rods to change (hypnosis), Charcot said due to nervous system

Question 20

Breuer and Freud

Answer 20

Breuer treated hysteria via hypnosis, talked about past (cathartic method), Jung said temporary fix and p used morphine. Fried: unconscious conflicts between I’d ego and superego . Defence mechanisms (denial, projection, displacement, regression, repression, rationalisation
),. Jung collective unconscious (archetypes, happened from working towards goals.

Question 21

Criteria for DID

Answer 21

Disruption in the normal consciousness, memory, identity, emotion, perception, motor control and behaviour
Criteria A- two or more distinct personality states, some cultures say possession, discontinuity in sense of self and agency
B- recurrent gaps in the recall of everyday events/ traumatic events

Question 22

First documented case of DID

Answer 22

jeanne fery was a dominican nun in 16thc france described in van der hart 1996, was disturbed had 21 month course treatment care by nuns and exorcists and she also made documents. Range of identities like Mary Magdalene, 7 deadly sins, sanguinnaire. Told by Magdalene that she had to leave the others

Question 23

Exorcism of anneliese michel

Answer 23

1952, religious family, seizures and depression, intolerant of religious objects , posses by 6 demons, 1-2 exorcisms a week and died from malnutrition and dehydration- no justice and made into a film the exorcism of Emily rose 2005

Question 24

Dissociation original definition- Pierre Janet

Answer 24

1886 traumatic events lead to extreme dissociation and multiple personalities and hysteria. Simple form is paralysis of a limb, complicated from is DID
Devils demons possess a person -witztum and van der hart 1993

Question 25

The case of Sybil

Answer 25

Schreiber ‘73- book on analysis of sybil (shohrley manson), 16 personalities brought together to a person called the blonde. Nathan 2011 found no evidence of alters, encouraged to create the,, Manson admitted she was lying. Most diagnosed were women, Wilbur wanted a did case and gave Sybil attention, she was suggestible

Question 26

The fantasy model - dalenberg

Answer 26

Dissociation propensity, mediators (fantasy proneness, absent minded, executive dysfunction, suggestibility- false memories of trauma (unreliable reports of trauma). Dalenberg: did intrinsic property

Question 27

Sociocognitive model merckelbach

Answer 27

Tendencies correlate with fantasy process and self reported childhood trauma but dissociation & fantasy link to trauma self reports. Piper and Merksey: the persistence of folly, culture bound due to leading Qs and suggestibility

Question 28

Trauma model

Answer 28

delenberg : trauma-mediators (genetics, developmental issues, stressors)-dissociation
Marmar: vietnam veterans reported many traumatic dissociative experiences (floating above a scene, not aware of things that happened, blanking out, disconnected from body)

Question 29

Dissociation and ptsd : carlson, Allen, dalenberg, carlson,

Answer 29

Carlson: relationships between ptsd severity and self reported dissociation. Allen: higher mean score of childhood trauma associated with more dissociation. Dalenberg and carlson- the model and avoidance is trying to reduce stress which can increase it

Question 30

Neurological studies of did Nicholson, sar, elzinga

Answer 30

Nicholson: those W ptsd and dissociation had enhanced amygdala frontal cortical activity (emotional consciousness and regulation). Sar- increased cerebral blood flow in did patients in frontal regions of host state . Elzinga: did had higher anxiety, less conc and more activity in pfc in working memory task . Due to pattern recognition, reinders could id people 74%. Those w derealisation don’t integrate info the same

Question 31

Problem and solution for mri studies in did

Answer 31

Reinders: people respond diff but findings can’t say origin and could be due to fantasy proneness . Study compared did vs high fantasy prone in 2 states neural identity (normal) or trauma identity. Did showed larger response to traumatic stim in tis and exaggerated response to neutral story

Question 32

Treatment -brand

Answer 32

Establish safety, alliance, grounding. 1. Safety, CBT, recalling traumatic events, coping strategies. Some reduced but not cured

Question 33

Etiology of did renaud and brain regions

Answer 33

When asking ps to wear goggles that distort visual info about where a person is being touched can produce temporary experiences of derealisation (renaud)
Brain regions that process bodily cues e.g. anterior cingulate cortex are underactive when viewing emotionally evocative images

Question 34

Criticisms of models of did

Answer 34

Child abuse occurring is subjective, abused people seek explanations for symptoms, did increased due to media and therapists (iatrogenic/created W treatment). Treatment reinforces as interview about identities. Boysen 2014: ppl can role play symptoms and produce diff personality tests . Postman 20l3: did performed same as controls in implicit memory but said didn’t remember first test