Issues in mental health

Question 1

Outline ancient beliefs on mental health (cause, who treated and treatment)

Answer 1

Causes:
Ancient Egyptians evil spirits were trapped inside your head.
China, positive and negative forces cause illness.

Normally a mother treated the sick.

Treatments:
Egyptians used ‘medicines’, a combination of ingredients that was said to cure the illness.
Trephination, a process where holes were drilled into people’s heads to release evil spirits.

Question 2

Outline middle ages beliefs on mental health (cause, who treated and treatment)

Answer 2

Causes:
The four humours (Galen)
Religion

Quack doctors treated the ill, they were unofficial and untrained. The church also treated the ill.

Bleeding and exorcism.

Question 3

Outline 16th to 17 century beliefs on mental health (cause, who treated and treatment)

Answer 3

Mental ill put in asylems and madhouses.

Seen as dangeous to society.

Treatments: purges, bleeding, and emetics (a drug that causes vomiting) were used.

“Gyrating chair” was intended to shake up the blood and tissues of the body to restore equilibrium.

Question 4

Outline 20th century century beliefs on mental health (cause, who treated and treatment)

Answer 4

People began to disagree with poor treatment in mental asylums.

Freud helped introduce therapy treatment.

ECT

NHS was formed in 1948

Question 5

What are the three ways to define abnormality?

Answer 5

Statistical infrequency

Deviation from social norms

Maladativeness

Question 6

What is statistical infrequency?

Answer 6

Behaviour that is statistically infrequent in the general population is considered abnormal.

Question 7

What are the strengths of defining abnormality using statistical infrequency?

Answer 7

High logical and measurable definition.

Clear cut to what is considered abnormal and normal.

High ecological validity as the method can be used to diagnose disorders solely based off data.

Objective

Question 8

What are the weaknesses of defining abnormality using statistical infrequency?

Answer 8

Subjective, no reasoning behind abnormality

Does not considered positive and negatives of abnormal behaviour.

Common disorders would not be considered statistically abnormal.

Cannot be compared between cultures.

Question 9

What is deviation from social norms?

Answer 9

These are actions or behaviour that can be seen as a departure from what one society or culture deems as acceptable.

Question 10

What are the strengths of defining abnormality using deviation from social norms?

Answer 10

Helps people, society gives itself the right to intervene abnormal behaviour.

Situational norms, adaptive over time and cultures

Can establish abnormality over a range of ages

Question 11

What are the weaknesses of defining abnormality using deviation from social norms?

Answer 11

Subjective, social norms are not real, based on opinions of people.

Change over time

Individualism, people that do not conform may be marginalised.

Ethnocentric bias in diagrnosises

Question 12

What is maladativness?

Answer 12

This refers to a person’s way of thinking, emotional responses or actual behaviour and if it is dangerous or prevents them from functioning healthily.

Question 13

What are the strengths of defining abnormality using maladativness?

Answer 13

It is a broader explanations and allows to individual differences, in some people’s case behaviour may seem abnormal but may not cause them any harm or risk.

Question 14

What is the aim of characterising mental disorders?

Answer 14

To classify abnormalities by psychiatrists and doctors with medical training who consider mental disorders as equivalent to other forms of illness.

Question 15

What are the two main diagnostic manuals.

Answer 15

DSM (diagnostic and statistical manual) used in the USA and UK

ICD (international classification of disease)

Question 16

What are the weaknesses of diagnosistic manuals?

Answer 16

Links with corporate pharmaceutical industry (69% of panel working on DSM5 had links with pharmaceutical companies)

Only describes disorders, but do not explain the cause or treatment.

The ICD/DSM are not the same, it lacks concurrent validity.

They can be used subjectively (Rosenhan’s study) and they might be subject to bias.

Question 17

What are the similarities between the ICD and DSM?

Answer 17

Both are diagnosing manuals which require two or more symptoms to be present in order for the diagnosis to be made.

They aren’t self-diagnosis manuals, they’re intended to be used by qualified health professions.

Both are officially recognised manuals used to categorize and diagnose mental disorders.

Question 18

What are the differences between the ICD and DSM?

Answer 18

The ICD is internationally used while the DSM is mainly used in America

The ICD contains all types of disorders while the DSM includes only mental disorders

Question 19

What was the aim of study 1 in Rosenhans research?

Answer 19

To find out whether normal, sane individuals would be admitted to psychiatric hospitals.

Question 20

What was the aim of study 2 in Rosenhans research?

Answer 20

Examine whether genuine patients would be misidentified as ‘sane’ by various hospital staff

Question 21

What was the sample used in study 1?

Answer 21

8 pseudopatients (3F, 5M) including Rosenhan.

They used fake names and careers, every other aspect of their life they hold the truth about.

12 hospitals were chosen across 5 different states (public and private).

Question 22

What was the procedure used in study 1?

Answer 22

Pseudopatients would organise a hospital appointment and claimed they had been hearing voices such as ‘empty’, ‘hollow’ and ‘thud’.

Pseudopatients that had been admitted they were told to act ‘normally’ and had to convince staff they were sane.

The IV were the 12 different hospitals

Question 23

What were the results of study 1?

Answer 23

All pseudopatients were admitted to all the hospital.

All except one patient were diagnosed with schizophrenia and release with ‘schizophrenia in remission’, they left with a label of their diagnosis.

There length of stay ranged from 7 to 52 days with an average of 19 days.

Question 24

How was powerlessness shown in study 1?

Answer 24

They have no control over their actions with no free will or choice over what is happening

Patients room could be entered and examined without warning or justification

Lack of confidentiality of patients notes, read openly

Patients personal hygiene and waste evacuation were monitored, toilets had no doors

Question 25

How was depersonalisation shown in study 1?

Answer 25

This is the loss of an identity when in a group, you are no longer treated as an individual with basic human rights.

Physical abuse of patients in front of other patients, other patients were not seen as credible witnesses

Many pills administered (2100)

Staff often distrusted and feared the patients which affected the treatment of their illness

The average contact time with doctoral staff per patient was 6.8 minutes

Question 26

What was the sample used in study 2?

Answer 26

Participants were psychiatric staff at one research and training hospital who had been briefed on the main study.

193 patients were judged.

Question 27

Outline the procedure used in study 2?

Answer 27

Staff were informed at some point during a three-month period, one or more pseudopatients would attempt to gain admission into the hospital.

A 10 point scale was used with ‘1’ reflecting the strongest belief that the patient was a pseudopatient and ‘10’ the strongest belief that the patient was genuine

Question 28

What were the results found from study 2?

Answer 28

41 patients high confidence they were pseudopatients.

No pseudopatients actually presented themselves to the hospital for admission for this period of the study.

Lack of reliability, type 2 error by identifying mentally ill patients as healthy.

Question 29

What were the conclusions from research by Rosenhan?

Answer 29

Psychiatrists are unable to reliably identify sane pseudopatients (type 1 error = false positive).

Psychiatrist also fail to reliability detect insanity (type 2 error = false negative)

Patients within a psychiatric environment maintain a label

Question 30

What is an affective disorder?

Include DSM criteria

Answer 30

An affective disorder affects the mood of individuals, an example of an affective disorder is depression.

DSM:
Five (or more) symptoms present during two week period including symptom 1 and 2.

Depressed mood most of the day, nearly every day

Less interest or pleasure in all or most activities most of the day

Body weight loss of more than 5 percent

Insomnia or excessive sleep

Feelings of worthlessness or inappropriate/excessive guilt nearly every day

Lack of ability to think, concentrate or make decisions nearly every day

Recurrent thoughts of death or suicide

Question 31

What is an psychotic disorder?

Include DSM criteria

Answer 31

Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. People with psychoses lose touch with reality. An example of a psychotic disorder is schizophrenia.

Two or more of the following in one month, at least one symptom must be shown of 1, 2 or 3.

• Delusions
• Hallucination
• Disorganized speech
• Grossly disorganized or catatonic behaviour
• Negative symptoms such as diminished emotions or expression

Question 32

What is an anxiety disorder?

Include DSM criteria

Answer 32

Significant feelings of anxiety and fear. Anxiety is a worry about future events and fear is a reaction to current events. An example of an anxiety disorder is agoraphobia

Marked fear or anxiety about two or more of these situations

• Using public transport
• Being in open spaces
• Being in enclosed
• Standing in line or in a crowd
• Being output of the home alone
• These situations almost provoke an anxiety attack, and the situations are actively avoided or require a companion.