Issues In Mental Health Flashcards
2 historical views on mental health
- prehistory (supernatural explanation)
- Greek culture (hum oral theory)
The cause and treatment of the supernatural explanations
-cause = believed to be possessed by a demon, or the behaviour was attributed to witchcraft. People also believed mental illness is related to wrongdoings.
- treatment = prayers and immersion in holy water for supernatural explanations. For demonic possessions exorcisms involving trephining, stretching, staving and immersions in freezing or boiling water.
The cause and treatment of the humoral theory
- Cause = 4 types of fluid in the body make up the personality: black bile, yellow bile, blood and phlegm. An imbalance of the fluids is what they believe to cause mental illness.
- treatments = purging the patients using emetics or laxatives and in extreme cases blood letting using leeches to drain the blood. Also changes to life style such as diet and/or exercise
2 ways for defining abnormality
- deviation from social norms
- failure to function adequately
What is the concept of deviating from social norms
Explains that what is considered ‘normal’ is determined by our society’s views of how we ought to act. Anyone who behaves differently and deviates from the social norms are labelled as abnormal.
What is classified as abnormal with be determined by culture, historical context, age, gender and the situational context. e.g. until 1973 homosexuality was deemed as abnormal however now it’s not, yet it’s still illegal in over 70 countries showing how social norms differ according to time and culture.
However people that are seen as eccentric can also be seen as abnormal as they don’t follow social norms and their lifestyle may be different to others.
What is the concept of failure to function adequately
From an individuals point of view abnormality can be seen as not coping with everyday living. Such as eating, communicating and doing washing.
Not functioning adequately cause distress and suffering to the individual and possibly for others too. People with schizophrenia often lack awareness that anything is wrong.
The failure to function criteria may differ for different cultures because the standard of one culture is being sued to measure another. This is why lower-class is often diagnosed with mental illnesses because their lifestyle is different to dominant culture may lead to judgment of failing to function adequately.
Some dysfunctional behaviour can be functional for an individual, such as cross dressing may be considered as failure to function adequately however may help the individual to cope with stress and increase their self-esteem
Ways to categorise mental health
- DSM
- ICD
The history of the ICD
Stands for international statistical classification of diseases and related health problems.
The first international list of causes of death (1893) was as a way to monitor morality and morbidity.
It is used by physicians, nurses, researchers etc.
Used to study disease patterns as well as in clinical care to monitor outcomes, allocate resources and manage healthcare.
It’s a book on both mental disorders and physical disorders
ICD-10
Is the 10th version of this classification tool. There are 21 chapters each with several categories and subcategories.
In chapter V there are 11 subcategories such as:
- mood disorders (affective) = mani + bipolar etc
- schizophrenia disorder + delusional disorders
- also disorders of psychological development, mental and behavioural disorders due to psychoactive substances
The history of the DSM
Stands for diagnostic and statistical manual of mental disorders
First DSM based on classification system used with soldiers in ww2 released in 1952.
Current edition released in 2013 and is the 5th edition.
Used in the USA not worldwide.
DSM-5
DSM-5 lists around 300 disorders and is divided into 3 main sections.
1.) describes the process of revising the DSM and how the current manual can be used
2.) includes 20 categories of disorders e.g. schizophrenia, depression, psychotic disorders, and anxiety disorders. Also includes substance addictive disorders, gender dysphoria and eating disorders
3.) provides assessment tools for specific disorders and disorders in general. And includes disorders that appear to exist but need further research e.g. caffeine use disorders do gaming disorder
Rosenhan (1973) background and aims
Background = psychiatrists + psychotherapists started to criticised the medical model of abnormality in 1960. Known as the anti-psychiatry movement. Rosenhan was apart of it. Wondered if there was any way to reliably identify who is abnormal.
Aim = whether a diagnosis of insanity is based on characteristics of the patients themselves or the context in which the patient is seen. Aim was to test the validity of and reliability of psychiatric diagnosis.
Rosenhan (1973) study 1
(Aim,method,procedure,results)
- Aim = to see whether a group of sane people presenting themselves of having a disorder would be diagnosed as insane in a psychiatric hospital.
- method:
~sample = ppts were patients and staff as 12 psychiatric hospitals in 5 different states which were a considerable range (size, funding, age). Asked 8 pseudo-patients to pretend to be suffering from a mental illness (confederates).
~research method = participant observation as pseudo-patients pretended to be real patients and Ivory for the hospital. - procedure = pseudo patients phoned hospital to ask for appt. when arrived explain they were hear voices (schizophrenia symptom). Used the words empty, hollow, thud. All gave a false name and false jobs for those who work in the medical profession. Once admitted patients acted normal and when asked said they were no longer experiencing symptoms. Had to convince staff they were sane to be released.
- results = all but one diagnosed with schizophrenia and discharged with diagnosis of schizophrenia in remission. Remained in hospital for 7 - 52 days. Real patients suspected them. Normal behaviour was now seen as a symptom of schizophrenia. Patients lacked privacy. Experienced depersonalisation which lead to overwhelming feeling of powerlessness.
Rosenhan (1973) study 2
(Aim,method,procedure,results)
- aim = to see whether psychiatrists would be under cautious rather than over cautious
- method:
~ sample = the hospital which was told the results of study 1 (used in study 1)
~ research method = questionnaire - procedure = staff informed that in the next 3 months one or more pseudo patients would be admitted. All staff member asked to rate anyone admitted on a scale of 1-10 (1 being highly confident they are a pseudo patient)
- results = over 3 months 193 patients admitted. The number judged to be pseudo patients was: 41 by at least one staff member. 23 by one psychiatrist. 19 by one psychiatrist and one other staff member
Rosenhan (1973) conclusion
Shows diagnosis was not valid because the psychiatrist failed to distinguish the sane from the insane. The over diagnosis in study 1 shows psychiatrist would rather call a healthy person sick than a sick person healthy as it is more dangerous to under diagnose than over.
In the 2nd study they were calling a sick person healthy to avoid being caught over diagnosing again.
Results frightening as the lack of accuracy can have disastrous consequences of those incorrectly diagnosed.
Rosenhan noted the stickiness of psychiatric labels. That behaviour is likely to be determined by the situation rather than the individual.
