historical context Flashcards
rosenhan and seligman’s four definitions of defining abnormality?
statistical infrequency
deviation from social norms
failure to function adequately
deviation from ideal mental health
statistical infrequency?
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
statistical infrequency evaluation?
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
deviation from social norms?
all cultures have standards of acceptable behaviour
behaviour deviating from these norms is seen as abnormal
deviation from social norms evaluation?
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
failure to function normally (maladaptiveness)?
inability to lead a normal life or engage in normal behaviour
dysfunctional behaviour, personal distress, observer discomfort, unpredictable behaviour, irrational behaviour
failure to function normally (maladaptiveness) evaluation?
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
deviation from ideal mental health?
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
deviation from ideal mental health evaluation?
jahoda’s criteria are only applicable to western cultures
but are helpful within these
highly subjective
icd?
international classification of diseases
chapter 5 is on mental and behavioural disorders
classified into 11 main categories
dsm stands for…?
diagnostic statistics manual
dsm basics?
only mental health
compiled by american psychiatric association
aim: provide a practical diagnosis guide
dsm more holistic than icd
first axis of dsm?
clinical syndromes, all mental disorders except personality disorders and mental retardation
second axis of dsm?
personality disorders and mental retardation
third axis of dsm?
general medical conditions that could lead to disorders of axes one and two
fourth axis of dsm?
psychosocial and environmental problems that might influence diagnosis
fifth axis of dsm?
assessment of functioning, evaluated on a 1-100pt scale
how is dsm-v used?
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
advantages of categorisation?
improves reliability of diagnosis between physicians
providing a diagnosis allows for support to be obtained
regularly monitored and updated
disadvantages of categorisation?
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
rosenhan aim?
to answer the question ‘can we tell the difference between the sane and insane?’
rosenhan expt one aims?
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
rosenhan expt one sample?
staff and patients of 12 psychiatric hospitals across 5 US states
range of different types, including old to new, public, private and university
rosenhan study one method?
covert participant observation / field experiment
about the pseudo-patients?
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’
rosenhan results: stay time?
7-52 days, 19 day average
rosenhan results: patients doubting diagnosis?
in three trials, 35 of 118 patients recognised pseudo-patient sanity
rosenhan results: experiences with nurses?
nurses were in offices 90% of the time and ignored patients questioning of when they would be released 88% of the time
rosenhan study two aim?
could the tendency of diagnosing sane as insane be reversed?
how did rosenhan’s second study work?
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
rosenhan study two results?
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
affective disorders?
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
characteristics of major depressive disorder?
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)
dsm-v diagnostic criteria for major depressive disorder?
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
psychotic disorders?
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
characteristics of schizophrenia?
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
dsm-v diagnostic criteria for schizophrenia?
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
anxiety disorders?
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
characteristics of specific phobias?
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
dsm-v diagnostic criteria for specific phobias?
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
