historical context of mental health

Question 1

causes of mental illness in the ancient times

Answer 1

possession of devils, punishment from God

Question 2

treatment for mental illness in the ancient times

Answer 2

exorcisms and trepanation

Question 3

causes of mental illness in the 18th century

Answer 3

imbalance of the 4 bodily humours - black bile, yellow bile, blood and phlegm

Question 4

treatment for mental illness in the 18th century

Answer 4

bloodletting, swinging chairs and cold water baths

Question 5

causes of mental illness in the 20th century

Answer 5

unconscious conflicts and chemical imbalances

Question 6

treatments of mental illness in the 20th century

Answer 6

psychoanalysis, electroshock therapy and lobotomies

Question 7

4 definitions of abnormality

Answer 7

statistical infrequency, deviation from social norms, failure to function and deviation from ideal mental health

Question 8

statistical infrequency

Answer 8

a behaviour that is statistically not seen in society often may be considered abnormal
e.g. 3.45% had schizophrenia in 2012

Question 9

deviation from social norms

Answer 9

a person who doesnt behave in the way society expects may be considered abnormal
e.g. being unemployed or taking drugs

Question 10

failure to function adequately

Answer 10

if a person is unable to live a normal life adequately then they are considered abnormal
e.g. OCD, agoraphobia or dramatic mood swings

Question 11

deviation from ideal mental health

Answer 11

if you lack ideal mental health you are considered abnormal.
failing to meet the criteria for ideal mental health (Jahoda) means ideal mental health
1. positive attitude towards self
2. growth development
3. control over behaviour
4. perception of reality
5. adequacy in love
6. resistance to stress

Question 12

drawbacks of statistical infrequency

Answer 12

positive behaviour may be statistically infrequent, therefore, considered abnormal but need help

Question 13

drawbacks of deviation from social norms

Answer 13

some behaviour will be considered abnormal in some cultures and in others it is normal.

Question 14

drawbacks of failure to function adequately

Answer 14

cross over between normal and abnormal behaviour
e.g. not being upset due to death is abnormal, but being upset all the time is abnormal

Question 15

drawbacks of deviation from ideal mental health

Answer 15

the criteria is unrealistic as not everyone wants to strive to full potential

Question 16

two ways to categorise disorders

Answer 16

ICD-11 and DSM-5

Question 17

ICD-11

Answer 17

international classification of diseases.
published by the world health organisation (WHO).

Question 18

DSM-5

Answer 18

diagnostic statistical manual
split into 3 sections
made by the American Psychiatric Association (APA)

Question 19

positives of the ICD and DSM

Answer 19

+ reliable - both are systematic so can be used by everyone to make diagnoses.
+ multiple updates, keeping up to date
+ holistic, multiple psychiatrists put the manuals together
+ useful, easy to diagnose and treat people

Question 20

negatives of the ICD and DSM

Answer 20

• little understanding of causes, unreliable diagnoses
• the same drug is given to patients with a specific disorder, not specialised to the patient
• gender stereotypes

Question 21

rosenhan - aim

Answer 21

to see if people can tell the difference between sanity and insanity and to explore how patients are treated within an institution

Question 22

rosenhan - M,D,S - study 1

Answer 22

field experiment using participant observation
8 confederates (3F 5M) who act as pseudo patients
12 psychiatric hospitals across 5 states in the USA

Question 23

rosenhan - procedure - study 1

Answer 23

1. pseudopatients call the hospital for an appointment
2. arrive complaining of hearing voices saying ‘empty’ , ‘hollow’ and ‘thud’
3. pseudopatients gave false names, jobs and symptoms but real life symptoms
   4.on the ward the pseudopatients behaved normally and attempted to engage in conversation. when asked by staff how they were feeling they say they were fine and no longer experienced symptoms.
   4.the pseudopatients would make notes about their observations
4. at 4/12 an observation on the staff was carried out. the pseudopatients approached the staff asking “when am i likely to be discharged?” (the results were compared to study 3)

Question 24

rosenhan - results - study 1

Answer 24

11 pseudopatients were diagnosed with schizophrenia and 1 with manic depression.
7-52 days stays, average 19 days
35 genuine patients had suspicions about the sanity of pseudopatients saying “you are not crazy”
pseudopatients were not detected by staff
pseudopatients described the experience as depersonalising and made them powerlessness
the staff made type 1 errors

Question 25

rosenhan - study 2

Answer 25

an observation
1. the staff at a hospital were told pseudopatients would be sent and the staff needed to recognise them
2. for every new patient each staff member rated the likelihood that they were pseudopatients.
3. no pseudopatients were sent

Question 26

rosenhan - results - study 2

Answer 26

staff incorrectly rated 83/193 patients ad pseudopatients
this was a type 2 error
rosenhan found that behaviour of pseudopatients was interpreted in accordance to their diagnosis. this is the stickiness of labels.
rosenhan said that we should focus on the specific problems of the patient

Question 27

rosenhan - aim - study 3

Answer 27

to compare patient -staff contact with student - faculty member contact

Question 28

rosenhan - procedure - study 3

Answer 28

IV - hospital or university
condition 1: hospital
in 4 hospitals pseudopatients asked the staff one of three questions
e.g. “ will i be discharged?”

condition 2: university
at stanford university a female student approached a faculty member 6 questions e.g. “is there financial aid?:

Question 29

rosenhan - results - study 3

Answer 29

10% of nurses made contact, but 100% of staff
88% of nursers walked on, but 0% of staff
0.5% of nurses stopped to talk, but 100% of staff

Question 30

conclusions of rosenhan

Answer 30

it is hard to diagnose mental illness
stigma regarding labelling
psychiatric hospitals are unpleasant

Question 31

positives of rosenhan

Answer 31

+ high eco validity, carried out in real hospitals
+ covert observation, no demand characteristics

Question 32

negatives of rosenhan

Answer 32

• small and unrepresentative sample, only 8 people
  -unethical, deception of medical staff, distress to staff and patients
  -lacks population validity/ethnocentric, only uses American hospitals

Question 33

what is meant by an affective disorder

Answer 33

disorders affecting mood e.g. depression/bipolar/anxiety

Question 34

symptoms and prevalence of depression

Answer 34

difficulty continuing social, work or domestic activities
having a loss of interest or enjoyment
increased fatigue
reduced concentration, insomnia, pessimism and ideas of harm
10% of population

Question 35

what is meant by an anxiety disorder

Answer 35

phobias
triggering the autonomic nervous system
intense and irrational fear

Question 36

symptoms and prevalence of phobias

Answer 36

increased heart rate, muscle tension, sweating and shaking
7-12% of the population

Question 37

what is meant by a psychotic disorder

Answer 37

serious illness which affect the mind making it hard to think clearly and make good judgement

Question 38

symptoms and prevalence of schizophrenia

Answer 38

symptoms must be present for 1 month
symptoms include loss of reality, hallucinations and intense jealousy
positive symptoms - behaviour in addition to healthy behaviour e.g. hallucinations or delusions
negative symptoms - behaviour lacking from healthy behaviour e.g. outward emotion
peak age 18M, 30F