historical context of mental health Flashcards
causes of mental illness in the ancient times
possession of devils, punishment from God
treatment for mental illness in the ancient times
exorcisms and trepanation
causes of mental illness in the 18th century
imbalance of the 4 bodily humours - black bile, yellow bile, blood and phlegm
treatment for mental illness in the 18th century
bloodletting, swinging chairs and cold water baths
causes of mental illness in the 20th century
unconscious conflicts and chemical imbalances
treatments of mental illness in the 20th century
psychoanalysis, electroshock therapy and lobotomies
4 definitions of abnormality
statistical infrequency, deviation from social norms, failure to function and deviation from ideal mental health
statistical infrequency
a behaviour that is statistically not seen in society often may be considered abnormal
e.g. 3.45% had schizophrenia in 2012
deviation from social norms
a person who doesnt behave in the way society expects may be considered abnormal
e.g. being unemployed or taking drugs
failure to function adequately
if a person is unable to live a normal life adequately then they are considered abnormal
e.g. OCD, agoraphobia or dramatic mood swings
deviation from ideal mental health
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
drawbacks of statistical infrequency
positive behaviour may be statistically infrequent, therefore, considered abnormal but need help
drawbacks of deviation from social norms
some behaviour will be considered abnormal in some cultures and in others it is normal.
drawbacks of failure to function adequately
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
drawbacks of deviation from ideal mental health
the criteria is unrealistic as not everyone wants to strive to full potential
two ways to categorise disorders
ICD-11 and DSM-5
ICD-11
international classification of diseases.
published by the world health organisation (WHO).
DSM-5
diagnostic statistical manual
split into 3 sections
made by the American Psychiatric Association (APA)
positives of the ICD and DSM
+ 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
negatives of the ICD and DSM
- little understanding of causes, unreliable diagnoses
- the same drug is given to patients with a specific disorder, not specialised to the patient
- gender stereotypes
rosenhan - aim
to see if people can tell the difference between sanity and insanity and to explore how patients are treated within an institution
rosenhan - M,D,S - study 1
field experiment using participant observation
8 confederates (3F 5M) who act as pseudo patients
12 psychiatric hospitals across 5 states in the USA
rosenhan - procedure - study 1
- pseudopatients call the hospital for an appointment
- arrive complaining of hearing voices saying ‘empty’ , ‘hollow’ and ‘thud’
- 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 - 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)
rosenhan - results - study 1
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
rosenhan - study 2
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
rosenhan - results - study 2
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
rosenhan - aim - study 3
to compare patient -staff contact with student - faculty member contact
rosenhan - procedure - study 3
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?:
rosenhan - results - study 3
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
conclusions of rosenhan
it is hard to diagnose mental illness
stigma regarding labelling
psychiatric hospitals are unpleasant
positives of rosenhan
+ high eco validity, carried out in real hospitals
+ covert observation, no demand characteristics
negatives of rosenhan
- 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
what is meant by an affective disorder
disorders affecting mood e.g. depression/bipolar
symptoms and prevalence of depression
difficulty continuing social, work or domestic activities
having a loss of interest or enjoyment
increased fatigue
reduced concentration, insomnia, pessimism and ideas of self harm
10% have attempted to commit suicide
women twice as likely to be diagnosed.
10% of population have depression.
peak age 30-40
what is meant by an anxiety disorder
phobias
triggering the autonomic nervous system
intense and irrational fear
symptoms and prevalence of phobias
increased heart rate, muscle tension, sweating and shaking
7-12% of the population
what is meant by a psychotic disorder
loss of contact with reality.
affects the mind making it hard to think clearly and make good judgement.
symptoms and prevalence of schizophrenia
symptoms must be present for 1 month, and disturbance for 6 months.
positive symptoms - behaviour in addition to healthy behaviour e.g. hallucinations or delusions
negative symptoms - behaviour lacking from healthy behaviour e.g. catatonia (no movement or speech), and anhedonia (decrease in outward expression of emotion)
peak age 18M, 30F
