history of mental health Flashcards
describe historical beliefs about causes of mental health
- spiritual: those who experienced poor mental health were possessed by demons
-spiritual: poor mental health was a punishment from god
hippocrates and galen- four humour theory: poor mental health was due to an imbalance of the four bodily humours (black bile, yellow bile, phlegm and blood) e.g depression is caused by excess black bile
in the late 19th century, varying influences began to be acknowledged e.g bilogical, social and psychological
describe historical treatments of mental health
trepanation- drilling holes into the skull to release demons
blood letting or purging to balance the four humours
exoricisms including starvation and physical restraint to rid the demons from the patient
talk therapy and psychoanalysis introduced in the 19th century
lobotomy- a surgical procedure that severs connections in the prefrontal cortex
medication and behavioural therapies introduced post 1950s
what are the four definitions of abnormality
1.statistical infrequency
2.deviation from social norms
3.failure to function adequately
4.deviation from ideal mental health
what is statistical infrequency
a behaviour that is statistically not seen often in society may be considered abnormal
e.g 3.45% of the UK population had schizophrenia in 2012 which is statistically infrequent
evaluate statistical infrequency
- some infrequent behaviours are actually desirable and we wouldnt class this as ill mental health e.g having a high IQ or photographic memory
- who decides the arbitrary cut offs for statistical infrequency- this is subjective and arguably not useful when diagnosing disorders based on statistics such as anorexia
what is deviation from social norms
a person who doesnt behave in a way that society expects may be considered abnormal
e.g taking class A drugs like heroin even tho it is illegal to do so
some behaviours are considered abnormal in some cultures but are normal in others e.g in western culture it is normal for women to wear trousers but in other cultures this would be seen as abnormal
evaluate deviation from social norms
- who decides what the social norm is and how can this be agreed upon when modern society is diverse and multicultural- it is too subjective
what is failure to function adequately
if a person is unable to live a normal life adequately then they are considered abnormal
e.g a gambling addict spending all their money on gambling so they can no longer afford their mortgage or sufficient food
ways people can fail to function: unpredictable behaviour e.g mood swings, irrational behaviour e.g thinking your being watched, behaviour that makes the observer uncomfortable e.g talking to yourself and dysfunctional behaviour e.g ocd
evaluate failure to function adequately
-people may fail to function for reasons such as grief due to loss of a loved one. this does not mean they are experiencing mental illness
-people may function outwardly quite well and show no signs of ill mental health but be experiencing this internally
what is deviation from ideal mental health
if you lack ideal mental health you are considered abnormal
jahoda developed a criteria for ideal mental health which included: resistance to stress and frustration, positive attitudes towards the self, true perception of reality and voluntary control over behaviour
evaluate deviation from ideal mental health
- this is an unrealistic measure and critics would argue that having such a criteria would have adverse effects and cause people to feel inadequate and possibly cause self fulfilling prophecy
what is the ICD and how has it changed over time
the ICD is the international classification of diseases- it is the standard manual used to classify all general diseases and illnesses, created by the World Health Organisation
it is now in its 11th edition and has a chapter for mental health disorders
the ICD-10 had 14400 items but the ICD-11 has 55000. this shows that diagnosis and what we class as an illness or disease is rapidly changing e.g the removal of transexualism from the mental health section of the ICD which has now moved to the sexual health section. also the inclusion of things such as weapons which could harm a person e.g a knife or a comb
what is the DSM and how has it changed over time
the DSM is a manual used only to classify mental health disorders and was made by the American Psychiatric Association.
it is only in its 5th edition and is the main manual used to diagose mental illness in america
describe similarities between the ICD and DSM
-both are high in temporal validity as they are regularly reviewed by official bodies
-both are reliable as they consist of lists with set criteria which makes it easier for clinicians to diagnose patients
describe differences between the ICD and DSM
- the DSM is more detailed regarding mental health diagnosis as it is a manual about only mental health whereas the ICD is a manual on all diseases and illnesses
-the ICD is international whereas the DSM is more american based
give strengths on how mental health is categorised (ICD and DSM)
+ high in temporal validity as they are both often reviewed by official bodies
+ high in validity and reliability as disorders are removed if people arent being diagnosed properly
+useful- the ICD is translated into 43 different countries, making it accessible to many doctors to diagnose their patients
give weaknesses on how mental health is categorised (ICD and DSM)
-the manuals help diagnose but do not provide information on explanations of treatments for disorders
-low in validity as a high percentage of the panel working on the DSM had pharmaecutical relations
-studies showed that no disorder has a high inter-rater reliability for diagnoses
what was the aim of rosenhans study
to examine diagnoses of sanity/insanity and to see how situational factors bias a diagnosis
to see if people can tell the difference between sanity and insanity and to see how patients in institutions are treated
what was the method of rosenhans study
field experiment using participant observation
who were the participants
8 pseudopatients (3f/5m) but the real participants were the hospital staff who were unaware of the study
where did the experiment take place
12 psychiatric hospitals- a range of new, old, large, small, private and state run institutions
describe the procedure of rosenhans experiment
the pseudopatient called the hospital for an appointment
they arrived complaining of hearing voices saying “empty”, “hollow” and “thud”. the voices were unfamilliar and the same sex as the pseudopatient
it was believed that the psychiatrists would go for a diagnosis of schizophrenia due to the voices and delusions.
pseudopatients gave fake names and occupations but used their real life histories
once on the ward, pseudopatients took part in ward activities and speaking to patients and staff.
when asked by the staff how they were feeling they said they were no longer experiencing symptoms but were told they would have to try to convince the staff they were sane to be discharged
pseudpatients spent time writing their observations. this was initially done secretly but was done more openly after realising the staff didnt care
what were the results
staff diagnosed 11 pseudopatients with scizophrenia and one with manic depression’
the staff never detected their sanity but 35 real patients did
the average hospital stay was 19 days and all pseudopatients were released with schizophrenia in remission- this shows what rosenhan called stickiness of labels- once you have a diagnosis it never goes away
what did rosenhan conclude
the experience of hospitalisation was one of powerlessness and depersonalisation
patients were deprived of many human rights such as privacy e.g there were no doors on the toilets and all medical records were available to all staff members
patients often faced brutality from the staff. this would never be done infront of another staff member because they were seen as a credible witness whereas the patients were not
the pseudopatients were given a total of 2100 tablets, only two of which were swallowed. the rest were flushed down the toilet. upon going to flush their tablet, pseudopatients found medication packaging of other patients who had also disposed of their medication- shows how neglected they were
psychiatrists and psychologists spent on average 7 minutes a day interacting with patients- who theyre meant to be taking care of
