IMH Flashcards
Historical context: supernatural explanation
Animism
- everyone has a soul
- evil spirits have taken possession over a human body
- called ‘parasitic spirits’ can be animals, ancestors
- enter through work of magic evildoer or lack of faith
- use trepanning (hole in brain) to allow spirits to escape to treat
Historical context: somatogenic explanation
Humourism
Hippocrates first to identify mental illness as scientific
Mental health issues a result of the imbalance of 4 humours (blood, black bile, yellow bile, phlegm)
Eg. Excess yellow bile is anxiety
Eg. Excess black bile depression (laxatives)
Historical context: Rosenhan & Seligman 4 ways defining abnormality
Statistical infrequency
Failure to function adequately
Deviation from social norms
Deviation from ideal mental health
Historical context: define abnormality- statistical infrequency
Anything statistically rare is abnormal
Eg. 3.45% UK population schizophrenic
Historical context: define abnormality- failure to function adequately
This is when they are unable to perform tasks in everyday life that are social expectations
Eg. Not going to work, not maintaining hygiene
Historical context: define abnormality- deviation from social norms
Don’t demonstrate expected/approved behaviour by society
Eg. 80 y/o becoming punk defies social norms of age group
Historical context: define abnormality- deviation from ideal mental health
Ideal mental health: - positive - independent - accurate perceptions of reality - positive social interaction Deviate from this if: - maladaptiveness - unpredictable - inaccurate perceptions of reality - suffer from consequences of their own behaviour
Historical context: categorising mental disorders- DSM-5
Version 5 published 2013 - 22 categories of mental health disorders Example of category: Anxiety disorders - specific phobias - social phobia - panic disorder There are also.. Internalising disorders: - mood (cognitive symptoms) Externalising disorders: - impulsive, disruptive (behavioural symptoms)
Historical context: aim
Rosenhan
See if mental hospitals in USA could tell sane from insane
Historical context: sample
Rosenhan
12 hospitals from 5 states in USA
Historical context: Rosenhan general method
8 same people phoned 12 mental hospitals
- reported hearing voice of the same sex saying ‘empty’ ‘hollow’ ‘thud’
- once admitted to hospital they stopped simulating any symptoms, took part in regular activities
- took notes on staff and patients
- all admitted
Historical context: Method
Rosenhan (follow up)
Told sending one or more pseudo patients to a hospital to try and be admitted
- staff rate each person how likely they were a real patient 1/2 (confident pseudo)
Historical context: results
Rosenhan
11 hospitals gave diagnosis schizophrenia, 1 diagnosed manic depression
- average 19 days hospital
- never discovered as fake
- real patients suspected ‘you’re not crazy’ accused of being journalist
- patient beaten in front of other patients
Historical context: results
Rosenhan (follow up)
At least 1 staff member rated 41 patients as pseudo
At least 1 psychiatrist rated 23 as pseudo
Historical context: characteristics of an affective disorder
Depression:
Have to have 1/2 symptoms:
- depressed mood most of day, nearly everyday
- markedly diminished interest of pleasure in almost all activities most of day, nearly everyday
5+ symptoms altogether within 2 weeks:
- insomnia/excessive sleep
- fatigue/loss of energy
- lack of ability to think, concentrate, decisions
(All nearly everyday)
Symptoms must not be caused by anything else and cause clinically significant distress/impairment in functioning
Historical context: characteristics of psychotic disorder
Schizophrenia Two or more symptoms in one month: 1 symptom must be - delusion - hallucination - disorganised speech Second one can be: - grossly disorganised/catatonic behaviour - diminished emotional expression Positive symptoms is addition of new behaviours Negative symptoms takes away normal behaviours - level of functioning should get lower
Historical context: characteristics of an anxiety disorder
Phobias - intense, severed and irrational fear that produced physiological response (may go extreme lengths to avoid) Can be classified specific, agoraphobia, social phobia Agoraphobia: marked fear/anxiety about two or more: - public transport - enclosed spaces - outside of home alone - being in open spaces - standing in crowd Almost always provoked anxiety attack
Alternative to medical model: behaviourist (classical conditioning)
Watson & Raynor
- when white rat with Albert, loud noise made
- Albert soon associated the rat with the scary noise and cried when given the rat
- later generalised to white fluffy things like rabbits
Alternate to medical model: behaviourist- operant conditioning
Minor fears reinforced
Eg. Slight fear response of large dog- comfort from parents seen as a ‘reward’
- behaviour repeated to get the reward of comfort
Alternate to medical model: behaviourist- SLT
Behaviour observed and imitated
- child sees adult scared of spider, they imitate these fear responses
Alternate to medical model: cognitive explanation- Ellis
Faulty cognition:
Irrational thoughts can cause and sustain mental illness
Faulty cognitions can be summarised in 3 statements:
- I must be outstandingly competent, or I am worthless
- others must treat me considerably, or they are horrible
- the work should always give me happiness, or I will die
These are highly unrealistic expectations, therefore when not met, likely to feel like a failure and possibly lead to depression
Alternate to medical model: psychodynamic explanation
Unconscious memories & feelings will manifest themselves in abnormal behaviours and personality disorders
- often come from unresolved conflicts experienced as a child
- conflicts between Id, ego, superego create anxiety
Id:
- demands gratification
Superego:
- puts moral restraints on id
- if we have into id we will be punished with guilt
Ego:
- uses defence mechanisms to stop conflicts damaging ourselves (overuse can lead to disturbed behaviour)
Schizophrenia:
- ego controls demands of id and power of superego
- cold, rejecting mother can lead to ineffective ego (demand of id cannot be controlled)
- leads to loss accurate perception of reality (cannot tell where fantasies and and realities begin)
Treatment:
- psychoanalysis
- being unconscious to conscious to resolve conflict
Alternate to medical model: behaviourist treatments- systematic desensitisation
Shows hierarchy of stimuli from least fearful to most
(Shows picture of stimuli then eventually sees stimuli in flesh)
- patient taught relaxation techniques such as deep muscle relaxation
- therapist takes patient step by step through hierarchy
- at each stage techniques used until patient does not feel anxious anymore
- can apply newly learnt responses to real life settings
Alternate to medical model: behaviourist treatment- flooding
Present feared object directly
- immediate fear response caused by adrenaline is not sustainable and so will eventually calm down
- feeling of calm then associated
- can cause panic and reinforcement of phobia
Alternate to medical model: behaviourist treatment- aversion therapy
- produces unpleasant association
- often used for addiction
- drug called an emetic used to make people sick
- repeated pairings result in learned response of aversion to the substance
Alternate to medical model: treatment of specific disorder- cognitive
RET- Ellis
- looks for irrational thoughts when patients are ‘awfulizing’
- dispute beliefs through talking therapy
- modification of distorted thinking also invoked teaching patient how to regulate these so they can deal with it independently
A- activating event
B- beliefs
C- consequences
Therapy adds next steps
D- disputing
E- effects
Historical context: explanation- animalism
One thing that distinguishes humans from animals is ‘reason’
- people lost capacity of reason so we’re treated like an animal
- treatment aimed to restore reason:
- fear was emotion best suited to restore reason
- locked up, whipped
- beloved didn’t have sensitivities of humans
