Historical Views of Mental Health Flashcards
What were old methods of Treating Disorders ?
- Restraining devices
- Trepanning: to let evil spirits out
- Psychosurgery: remove or change parts of the brain (lobotomy)
- Electro-conclusive therapy
What are Newer treatments of treating disorders ?
- Prescription drugs
- Talking cures
- Cognitive behavioural therapy
What 4 types of definition for abnormality did Stratton and Hayes identify ?
- Statistical Infrequency
- Deviation from Social Norms
- Failure to function adequately
- Deviation from Ideal Mental Health
How does Statistical infrequency define abnormality ?
- Behaviours which are statistically infrequent
- Rare is abnormal
- Implies there is a normal curve for behaviours
What is the problem with using Statistical infrequency to define abnormality ?
-Doesn’t take into account desirability (own choice)
How does Deviation from social norms define abnormality. ?
- Breaking society’s standard of norms
- Abnormal behaviour violates society’s rules
What are criticisms of Deviation from social norms defining abnormality ?
- Who decides the social norms ?
- Different cultures have different rules
- Social norms change over time
- Expectations of men and women differ
How does Failure to function adequately define abnormality ?
- Failure to experience the normal range of emotions or behaviour
- Includes:dysfunctional behaviour, personal distress, observer discomfort, unpredictable behaviour and irrational behaviour.
What is the problem with Failure to function adequately defining abnormality ?
- Someone has to observe the behaviour (subjective)
- Hard to agree on the boundaries that define ‘functioning adequately’ - leading to inconsistency
- Are such things only indicative of poor mental health? Lack of employment could be due to poor education.
How does Deviation from ideal mental health define abnormality ?
- People should possess certain characteristics in order to be normal
- Positive view of self
- Having self discipline, act independently
- Positive social interactions
What is the problem with Deviation from ideal mental health defining abnormality ?
- Very subjective
- How positive do you have to be to normal
- We will all deviate from good mental health at some points in our lives – grief, stress, anger, love – but this is normal behaviour, not abnormal
What did Rosenhan and Seligman 1989 add about Deviation from ideal mental health defining abnormality?
- Suffering – the person has negative consequences to their behaviour.
- Maladaptiveness – not fitting in with society and maintaining normal social contacts.
- Unconventional behaviour – something that wouldn’t be expected in society
- Irrationality in behaviours that others wouldn’t be able to understand
- Unpredictability/loss of control that is not what we would expect.
- Observer discomfort due to the behaviour
- Violation of moral standards – where behaviour fails to meet the standards set by society.
What is Cultural Relativism ?
-Acceptable in one culture but not in another
What is Maladaptive ?
-Not fitting in with society
Which 2 Methods are used to categorise Mental Health ?
- DSM-V
- ICD-10
What does ICD-10 tell us about Mental Health?
- Each disorder has a description of the main features, and any important associated features.
- Each disorder is then given a code.
What does DSM-V tell us about Mental Health ?
- DSM is a multi-axial tool.
- Clinicians have to consider if a disorder is from Axis 1 (clinical disorders) and/or Axis 2 (personality disorders).
- Then the general medical condition of the patient is considered, plus any social and environmental problems.
What are the positives of DSM-V and ICD-10 ?
- Both generally accepted to be valid
- Encourage consistency
- DSM = more holistic, considers different factors (the axes)
- ICD – publication can look at the individual as a whole
- Both are constantly being updated
What are the negatives of DSM-V and ICD-10 ?
- Cultural bias may have/continue to influence the creation of the categories/axes
- Patients may fall into more than one category, complicating treatment
- ICD = categories are used in a reductionist way
- DSM – separates mind from body
What was the Aim of Rosenhan’s study ?
- Aimed to test the hypothesis that psychiatric diagnosis was neither reliable nor valid.
- Is it possible to distinguish the sane from the insane within a psychiatric institution?
What were the participants in Study 1 of Rosenhan’s experiment ?
- Staff at 12 different psychiatric hospitals in America.
- Range of old and new hospitals.
- Didn’t know that research was taking place.
What was the method of Rosenhan’s Study ?
- Field experiment
- Participant observation
What was the IV of Rosenhan’s Study ?
-Pseudo patients lack of symptoms
What was the DV of Rosenhan’s Study ?
-Staff’s response
How many Psuedo patients were there in Study 1 of Rosenhan’s experiment ?
- 8 including Rosenhan
- 3 women, 5 men
- Range of occupations
How did the Psuedopatients get admitted into the hospitals in Rosenhan’s study ?
- Each contacted the hospital for an appointment
- Claimed that they were hearing voices (of the same sex as them) saying words like ‘empty’, ‘hollow’ and ‘thud’.
- Used false names, but all the other information they supplied was accurate.
- All but one admitted with a diagnosis of schizophrenia.
What happened once the psuedopatients were admitted into hospital ?
- They stopped displaying any symptoms of abnormality and started behaving normally.
- Took notes on their experiences.
- Collected data on the way that the hospital staff interacted with the patients.
What were the results of Study 1 of Rosenhan’s experiment ?
- Length of time in hospital varied from 7 to 52 days
- Mean was 19 days.
- No detection by staff (although some patients were suspicious)
- Discharged with diagnosis ‘schizophrenia in remission’
- Staff made type 1 errors
How were behaviours interpreted within the context of schizophrenia in Study 1 of Rosenhan’s experiment ?
- Queuing early for lunch was described as ‘oral-acquisitive syndrome’.
- Taking notes was described as ‘writing behaviour’.
- Pacing the corridors in boredom led to patients being asked if they were ‘nervous’
What were the response rates of Rosenhan’s Study 1 ?
- Psychiatrist- 7% response rate
- Nurses- 3.6% response rate
How was powerlessness presented in Rosenhan’s Study ?
- Restricted contact with staff and inadequate personal privacy.
- Lack of confidentiality with patients’ notes – sometimes openly read by casual staff who had no therapeutic contact with the patient.
- Personal hygiene and toilet habits were monitored. -Cubicles had no doors.
How was depersonalisation presented in Rosenhan’s Study ?
- Ward staff engaged in physical abuse of patients in the presence of other patients – but not staff
- 2100 pills were administered to pseudopatients
What did Rosenhan believe was the causes of depersonalisation ?
- Staff attitudes towards the mentally ill. They may have distrusted and feared patients whilst also wanting to help them. This combination could have led them to avoid interaction with patients.
- Formal hierarchical hospital structure. Higher status staff had least contact with patients. They could have been role models to the other staff.
- Financial pressures, staff shortages, and over-reliance on medication to treat patients.
What were the participants in Study 2 of Rosenhan’s experiment ?
- Larger teaching and research hospital.
- Knew about the first study.
- Told to expect pseudo patients over the next three months.
What were the results of Study 2 of Rosenhan’s experiment ?
- 193 patients were rated – 41 suspected of being pseudo patients
- No pseudo-patients actually sent.
- Staff are making Type 2 errors (false negative) in attempt to avoid making Type 1 errors.
What was concluded from Rosenhan’s Study ?
- The process of diagnosis is open to many errors.
- The hospital environment and the ‘labels’ given to the patients influence perceptions of behaviour making them more likely to be interpreted as insane.
What is an example of an Affective Disorder ?
-Depression
What are symptoms of Depression ?
- Extreme sadness
- Loss of interest in usual activities-social withdrawal
- Weight loss or gain
- Thoughts of death or suicide
- Loss or more sleep
- Loss of energy
What is an example of an Anxiety Disorder ?
-OCD
What are symptoms of OCD?
- Recurrent. unwanted thoughts (obsessions)
- Repetitive behaviour (compulsions)
- Performing these rituals provides temporary relief from anxiety
What is an example of Psychotic Disorder ?
-Schizophrenia
What are positive symptoms of Schizophrenia ?
- Positive are a distortion or excess of normal function
- Hallucinations – perceptual disturbances that can be very frightening. For example hearing voices.
- Delusions – disturbances of thought involving false beliefs.E.G: paranoid delusions – believe they are being persecuted or plotted against.
- Disordered thinking and speech – cannot concentrate or sort thoughts into a logical sequence and communication may be difficult.
What are negative symptoms of Schizophrenia ?
- Negative are a reduction or loss of normal function.
- Affective (emotional) – a reduction in the range and intensity of emotional expression (flattening of emotion).
- Poverty of speech – reduction in speech, fluency and willingness to talk to others.
- Reduced motivation – spend whole days doing nothing
What is a type 1 error ?
- false positive
What is a type 2 error ?
-false negative
