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A LEVEL > Historical context of mental health > Flashcards

Historical context of mental health Flashcards

1
Q

What was believed about mental health in Ancient times?

A
  • Demonic possession
  • Caused by Gods if you had done wrong
  • Trepenation-dirilling of the skull to let spirits out.
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2
Q

What was believed about mental health in the Middle Ages?

A
  • as a result of demons and witchcraft
  • imbalance of 4 body fluids
  • blood letting and purging
  • exorcisms
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3
Q

What was believed about mental health in the 20th century?

A
  • biochemistry, cognitive, humanistic, behaviourism
  • Psychotherapy/Psychoanalysis
  • ECT
  • Drugs
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4
Q

What was believed about mental health in the 21st century?

A
  • genetic,biological,psychologicak,medical
  • Medication
  • Wellness
  • CBT
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5
Q

What was believed about mental health between 16th to 19th century?

A
  • Asylums such as Bedlam
  • Asylums seen like zoos
  • imprisonment/hospitalisation
  • protect society from ill
  • mixed attitudes between people
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6
Q

Deviation from social norms

A

Not abiding with social norms accepted/expected by society.

e.g. OCD excessively checking

However some symptoms such as tiredness and stress are not socially unacceptable.

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7
Q

Deviation from ideal mental health

A

You are abnormal if you don’t fit the criteria of good mental health.

e. g. ‘Good’ is categorised by:
- growth,development and self actualisation
- true perception of reality
- postitive attitude towards self

However there are opinions of what is normal- everyone has poor perception of self.

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8
Q

Failure to function adequately

A

Unable to live a normal life: hold down a job, maintain relationships, look after themselves. This means the disorder is affecting daily life.

e.g. Depression unable to hold down a job. Addiction unable to maintain self care. Autism can’t maintain relationships.

However may be another cause such as personality.

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9
Q

Statistical Infrequency

A

Not average compared to the rest of the population. (normal distribution curve)

e.g. Multiple personality disorder would be abnormal under this definition as less than 1% of population have it.

However some are more common such as depression and anxiety so not seen an abnormal.

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10
Q

ICD 10

A

2016

  • developed by WHO
  • og was a medical model for morbidity and 8th edition developed a mental health chapter
  • applied and research based form 23 WHO countries
  • diagnostic section: disorders grouped by common causes/ symptoms
  • clinicians need to identify type then variation
  • can be vague but trusts experienced doctors an clinical specialists.
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11
Q

ICD 11

A

2018

  • updated interactive web platform
  • 10 blocks of disorders now extended to 24
  • behavioural syndrome associated with psychical factors will each get own block (eating disorders)
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12
Q

DSM IV

A

1994

  • developed by American Psychiatric Association
  • by Americans for Americans
  • funded by pharmaceutical associations (clinical research, ones that require drugs)
  • multi-axil system of 5 broad groups
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13
Q

DSM 5

A

2013

  • all inclusive, considering all of a person’s functioning at once
  • has combined Autism with AS
  • changed how childhood disorders are defined(removal of childhood bipolar disorder with DMDD)
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14
Q

Anxiety Disorder definition and examples

A

Give a continuous feeling of fear ad anxiety which is disabling and can impose on daily functioning.

e.g. panic attacks, hobbies, PTSD, anxiety OCD

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15
Q

Anxiety Disorder Phobia DSM & ICD

A

Phobia-persistent fear of a particular objet or situation.

ICD 10-symptoms must be primary manifestations of anxiety. Phobia is avoided.

DSM 4/5-fear provokes an immediate response actively avoided out of proportion to actual danger. Has to last 6 months under 18. Disturbance does not fit into any other category.

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16
Q

Affective Disorder definition and examples

A

Affects your mood and behaviour so that you can’t function adequately.

e.g. depression, manic disorder, bipolar

17
Q

Affective Disorder Depression DSM & ICD

A

ICD10- depressed mood, loss of interest, increased fatigue. Minimum 2 weeks. Display 2/3 of the typical symptoms and 3/4 of atypical symptoms. Those moderate severe will have difficulty in continuing with social, work and domestic activities.

DSM 4/5-mist display 5 symptoms for over 2 weeks. not attributed to any other cause and causes significant distress.

18
Q

Psychotic Disorder definition and examples

A

Causes a loss of contact with reality. Causes a person to have hallucinations leading to confusion and disorientation.

e.g.schizophrenia, paraphrenia

19
Q

Psychotic Disorder Schizophrenia DSM & ICD

A

ICD 10-2 or more symptoms for 1 month. Positive symptoms: hallucinations, delusions. Negative symptoms: flat emotions. Cognitive deficits:disorganised thoughts/speech. 9 sub-types: paranoid (+), catatonic, disorganised, hebephrenic (-).

DSM 5- 2 or more symptoms for 1 month. For more than 6months then residual too. 5 main symptoms: delusions, hallucinations, disorganised speech/behaviours, social and occupational dysfunction.

20
Q

Rosenhan (1973)

Aim pt1

A

To test the reliability and validity of diagnosis of sanity by psychiatrists when presented with sans people, using the DSM2.

21
Q

Rosenhan (1973)
Sample
Method (3parts)

A

Patients and staff at 12 psychiatric hospitals across 5 states.

  • Field experiment
  • pt1 used participant observation
  • pt2 used a questionnaire
22
Q

Rosenhan (1973)

pt1 procedure

A
  • 8 pseudo patients telephoned the hospital saying that they had heard noises of the opposite sex saying things such as ‘empty’, ‘hollow’ and ‘thud’.
  • 7 admitted with schizophrenia and the other with bipolar. This shows it is fairly reliable but not valid as they were all sane.
  • little evidence to support that they had these disorders so the psychiatrists were seen as overcautious
  • acted normally in hospital, said they no longer had symptoms and had to prove their sanity to the staff.
  • many of the true patients suspected that the pseudo patients weren’t real.
23
Q

Rosenhan (1973)

pt1 data gathering

A
  • took notebooks and noted down the conditions of the hospital, staff and patients
  • qualitative data from observations on the abuse from some staff towards patients
  • quantitative data was collected by timing the length of interactions between staff and patients
24
Q

Rosenhan (1973)

pt1 results

A
  • pseudo patients seems as abnormal when queuing for lunch early and was seen as pathological behaviour
  • an account given about childhood and relationship details was described as a schizophrenic reaction
  • psychiatrists resounded to patients 4% of the 185 times
  • nurses responded 0.5% of the 1283 attempts
  • were is hospital average 19 days which ranged from 7-52
  • released with schizophrenia of remission
25
Q

Rosenhan (1973)

pt1 conclusions

A
  • type2 error occurred (really type1) due to incorrect diagnosis
  • ‘stickiness’ of the mental illness as still had ‘remission’
  • any normal behaviour was classed as a reaction
  • DSM2 had very low validity
26
Q

Rosenhan (1973)

Aim pt2

A

To see if staff would be under cautious having knowing about the miss diagnosis in the first experiment

27
Q

Rosenhan (1973)

Sample pt2

A

Staff at one psychiatric hospital who had been informed of the 1st lot of results and were disbelieving of the poor diagnosis.

28
Q

Rosenhan (1973)

pt2 method

A
  • Rosenhan said he would send in pseudo patients for staff to depict who was genuine. Planned to last 3 months.
  • didn’t send anyone
  • rated patients on a 10-point scale with 1 being that they had high confidence that the individual was a pseudo patient.
29
Q

Rosenhan (1973)

pt2 results

A

Out of the 193 patients admitted at the time, those thought to be pseudo patients were:

  • 41 by at least one staff member
  • 23 by one psychiatrist
30
Q

Rosenhan (1973)

pt2 Conclusions

A
  • Rosenhan said it was a Type 1 error as the hospital failed to diagnose ill patients properly (truly type 2)
  • staff were under cautious with diagnosis which questions the validity and accuracy of the DSM 2.

A LEVEL (15 decks)

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