historical context

Question 1

rosenhan and seligman’s four definitions of defining abnormality?

Answer 1

statistical infrequency

deviation from social norms

failure to function adequately

deviation from ideal mental health

Question 2

statistical infrequency?

Answer 2

behaviour is abnormal when it falls outside of the range for most people

many psychological features follow a ‘normal distribution’ such as happiness and intelligence

the extremes, such as mania and depression, are seen as abnormal

Question 3

statistical infrequency evaluation?

Answer 3

cut offs are arbitrary, one point can completely change whether you are considered abnormal

ignores desirability, low iq scores are looked down on while high are admired

some disorders are statistically common, such as depression and anxiety

cannot alone justify a diagnosis

Question 4

deviation from social norms?

Answer 4

all cultures have standards of acceptable behaviour

behaviour deviating from these norms is seen as abnormal

Question 5

deviation from social norms evaluation?

Answer 5

behaviours seen as acceptable vary vastly between cultures

suggests a sense of rightness coming from the dominant sectors of society

accepted behaviours change rapidly

highlights risk of socially constructed mental illnesses

homosexuality decriminalised in 1967 but in ICD until 1990

Question 6

failure to function normally (maladaptiveness)?

Answer 6

inability to lead a normal life or engage in normal behaviour

dysfunctional behaviour, personal distress, observer discomfort, unpredictable behaviour, irrational behaviour

Question 7

failure to function normally (maladaptiveness) evaluation?

Answer 7

allows for individual differences

behaviour may seem abnormal but if it’s not causing difficulty then it is written off without diagnosis

important to consider context

also what constitutes adequate functioning is cultural

Question 8

deviation from ideal mental health?

Answer 8

absence of normality constitutes abnormality

however normality just as hard to define

jahoda identified 6 factors of ideal mental health

positive self-view, personal growth and development, autonomy, positive relationships, accurate view of reality, master of own environment

Question 9

deviation from ideal mental health evaluation?

Answer 9

jahoda’s criteria are only applicable to western cultures

but are helpful within these

highly subjective

Question 10

icd?

Answer 10

international classification of diseases

chapter 5 is on mental and behavioural disorders

classified into 11 main categories

Question 11

dsm stands for…?

Answer 11

diagnostic statistics manual

Question 12

dsm basics?

Answer 12

only mental health

compiled by american psychiatric association

aim: provide a practical diagnosis guide

dsm more holistic than icd

Question 13

first axis of dsm?

Answer 13

clinical syndromes, all mental disorders except personality disorders and mental retardation

Question 14

second axis of dsm?

Answer 14

personality disorders and mental retardation

Question 15

third axis of dsm?

Answer 15

general medical conditions that could lead to disorders of axes one and two

Question 16

fourth axis of dsm?

Answer 16

psychosocial and environmental problems that might influence diagnosis

Question 17

fifth axis of dsm?

Answer 17

assessment of functioning, evaluated on a 1-100pt scale

Question 18

how is dsm-v used?

Answer 18

clinicians first decide if disorder is from axis one or two

then assess their physical, psychosocial and environmental factors for axes three and four

then give a global assessment for axis five

Question 19

advantages of categorisation?

Answer 19

improves reliability of diagnosis between physicians

providing a diagnosis allows for support to be obtained

regularly monitored and updated

Question 20

disadvantages of categorisation?

Answer 20

may be ethnocentric, creating a cultural bias

based on medical model, relying on a reliable method to measure mental health

wide range of individual differences and lack of scientific tests creates more categories creating an ever

Question 21

rosenhan aim?

Answer 21

to answer the question ‘can we tell the difference between the sane and insane?’

Question 22

rosenhan expt one aims?

Answer 22

could sane individuals get admitted to a psychiatric hospital?

if admitted, would they be recognised as sane and be released?

also planned to observe experience of being a patient in a psychiatric hospital

Question 23

rosenhan expt one sample?

Answer 23

staff and patients of 12 psychiatric hospitals across 5 US states

range of different types, including old to new, public, private and university

Question 24

rosenhan study one method?

Answer 24

covert participant observation / field experiment

Question 25

about the pseudo-patients?

Answer 25

8 pseudo-patients, 5m &3f

various jobs and ages, faked identities and made appointments to the hospitals

complained about hearing a familiar female voice saying ‘hollow’, ‘thud’ and ‘empty’

Question 26

rosenhan results: stay time?

Answer 26

7-52 days, 19 day average

Question 27

rosenhan results: patients doubting diagnosis?

Answer 27

in three trials, 35 of 118 patients recognised pseudo-patient sanity

Question 28

rosenhan results: experiences with nurses?

Answer 28

nurses were in offices 90% of the time and ignored patients questioning of when they would be released 88% of the time

Question 29

rosenhan study two aim?

Answer 29

could the tendency of diagnosing sane as insane be reversed?

Question 30

how did rosenhan’s second study work?

Answer 30

he called a hospital, saying that he would be sending a pseudo-patient in the next three months

staff members were to rate all admissions during this period on a 10pt scale

no pseudo-patients were sent

Question 31

rosenhan study two results?

Answer 31

193 patients admitted

41 rated as pp by at least one staff member

23 suspected by at least one psychiatrist

19 suspected by a psychiatrist and another staff member

Question 32

affective disorders?

Answer 32

mood disorders

intensity or dramatic changes affect a sufferers perceptions, thinking and behaviour which can disrupt their ability to function normally

moods can include sadness, despair, mania, euphoria or rage

Question 33

characteristics of major depressive disorder?

Answer 33

1 in 5 will suffer at some point in life

peaks at 18-29

apparent in all cultures

incidence x2 as high in females

can be reactive (external factors) or endogenous (internal factors)

Question 34

dsm-v diagnostic criteria for major depressive disorder?

Answer 34

five or more symptoms with at least one main symptom over past two weeks

main symptoms: low mood for most of the days, nearly everyday; loss of interest or enjoyment in activities (anhedonia)

other symptoms: energy change, appetite change, sleep disruption, worthlessness, guilt, loss of concentration, recurring thoughts of death, suicide ideation

symptoms should not be due to medication/a temporary response to something and should be serious enough to hinder day-to-day activities

Question 35

psychotic disorders?

Answer 35

sufferers lose contact with reality

many involves delusions or hallucinations leading the sufferer to perceive things around them very differently to others

often leads to sufferer withdrawing from the outside world

Question 36

characteristics of schizophrenia?

Answer 36

1 in 100 diagnosed in lifetime, 25% recovering after one episode, 50% improving but may still suffer and 25% never recovering

males and females at equal risk

risk increases for those in urban areas and for the working class

onset can be acute or gradual

Question 37

dsm-v diagnostic criteria for schizophrenia?

Answer 37

two or more symptoms with one main symptom that last 6 months and disrupt normal functioning

main symptoms: hallucinations, delusions, disorganised speech

other symptoms: highly disorganised, catatonic behaviour, negative symptoms (lack of outward emotion, motivation etc), thought insertion

diagnose if there’s no other explanation for symptoms, eg drug abuse

Question 38

anxiety disorders?

Answer 38

for 1 in 10, anxiety dominates life and is disabling

triggers for those with anxiety may seem trivial to others but threat seems real for sufferers

Question 39

characteristics of specific phobias?

Answer 39

affects ~6% of UK population and 75% of sufferers have multiple phobias

intense, severe and irrational fear which activates fight or flight response

five subgroups: zoophobias, environmental, blood-injection-injury, situational and other

more likely diagnosed in females and adolescents

Question 40

dsm-v diagnostic criteria for specific phobias?

Answer 40

phobic stimulus provokes immediate fear/anxiety & is deliberately avoided

fear/anxiety is disproportionate to actual danger

distress is persistent, 6 months+ and impairs function in area such as social life and work