issues in mental health topic 1- historical context

Question 1

background: demonic possession
a supernatural explanation

Answer 1

mental illness was believed to arise from evil spirits taking control of an individual and their behaviour -these could take a range of forms
treatment centred on creating holes (trepanning) in the possessed persons skull to let the evil spirits out

Question 2

background: humourism
a somatogenic explanation

Answer 2

Hippocrates believed the human body is made up of 4 bodily humours: blood,phlegm,yellow bile and black bile.
illness occurs when there is too much or too little of any of the humours.
-the sanguine humour= too much blood causes people to be changeable and inconsistent
-the phlegmatic humour=too much phlegm causes people to be sluggish and dull
-the choleric humour= too much yellow bile causes people to be irritable and aggressive
-the melancholic humour=too much black bile causes people to be moody and anxious
restoring balance is the solution achieved through diets,purgatives,bloodlettings and sexual abstinence

Question 3

background: animalism
based on a somatogenic explanation

Answer 3

‘lunatics’ sections consigned to the cellar of pennsylvania hospital and ‘their scalps shaved and blistered,bled,purged and chained to walls whilst keeper carried a whip’
they believed in theory of insanity where madness resulted from animalism and the insane has lost reason that distinguished humans from beasts
the first mandate of treatment was to restore reason by using fear on the disordered mind

Question 4

background: moral treatment

Answer 4

philippe pinel published articles on mental disorders and was appointed chief physician of asylum to practise his ideas on treatment of mentally ill patients in dungeons including removing chains to allow exercise, as well as changing hospital conditions to discontinue the use of blood letting, purging and physical abuse treatments
Pinel believed that mental disorders could be caused by psychological or social stress, congenital conditions or physiological injury rather than demonic possession
he argued for the humane treatment of mental patients including a friendly interaction between doctor and patient and for the maintenance and preservation of detailed case histories for the purpose of treatment and research

Question 5

background: defining abnormality
rosemham and selling an 4 ways

Answer 5

1 statistical infrequency:
any behaviour shown less often that the normal amount for society is abnormal as it’s rare
2. failure to function adequately:
if a person is unable to live a normal life adequately such as hold down a job, maintain a relationship or look after oneself
3. deviation from social norms:
a person who doesn’t abide by societies social norms
4. deviation from mental health:
if someone doesn’t have ideal mental health

Question 6

Background: categorising mental disorders
DSM-5:

Answer 6

categorising dysfunctional behaviour in several noteworthy ways:
-in chronological ‘lifespan’ order in accordance with when in a persons life the disorders are most likely to occur
-into 22 categorises
includes details on:
-diagnostic criteria
-gender related diagnostic issues
-culture related diagnostic issues

Question 7

defining abnormality ethnocentrism

Answer 7

diff cultures have diff social norms about what is normal and ‘abnormal’
e.g hearing voices may be totally acceptable in some cultures as part of religious practises

Question 8

defining abnormality usefulness

Answer 8

a bit too wide ranging to be of practical use and includes things that aren’t dysfunctional
however, can be useful as a first step towards the more specific kinds of categorising done

Question 9

defining abnormality reliability

Answer 9

deviation from social norms-
social norms change over time and depend on the social group.
function adequately could be subjective and depend on who you are comparing against
by settling a cult off statistical infrequency could be a constant way of defining abnormality

Question 10

defining abnormality validity

Answer 10

counts things as abnormal that aren’t:
-genius or high level artistic or sporting ability are rare but not abnormal
-children don’t have jobs or look after themselves
-ideas about functioning adequately are subjective and can be explained by other factors

Question 11

Rosenhan study on being sane in insane places
study 1

Answer 11

aim= too see if mental hospitals in the USA in the early 1970s could tell the sane from the insane
8 sane people phoning up for an appointment at 12 diff hospitals reporting symptoms of hearing voices of same sex-diagnosed to be schizophrenia. once admitted they stopped simulating any symptoms and took part in regular ward activities and took notes.
experiment: approached staff member to ask simple question to either psychiatrists or nurses vs study at uni asking for psychiatrist or internist vs asking to be directed at uni
found that people moved on with head averted only at psychiatric hospital, with much fewer stopping to talk

Question 12

Rosenhans study on being sane in insane places
study 2

Answer 12

hospital was aware that during the next 3 months one or more pseudo patients would attempt to be admitted into the hospital.
each member would rate on a 10 point scale each patients likelihood of being one
no pseudo patients attempted to be admitted during this period.
findings: 41/193 confidently rated by staff member, 23/193 by psychiatrist
conclusions:
mental hospitals in early 1970s in usa not good at making valid or reliable diagnosis
tended to view all behaviours as reflecting the disagnosis a patient had been given
patients were treated with profound disrespect

Question 13

application: characteristics of an effective disorder - depression

Answer 13

the characteristics of a major depressive episode according to DSM-5:
5+ symptoms in the same 2 week period:
-depressed mood most of the day nearly every day
-markedly diminished interest in all activities
other symptoms: fatigue, feelings of worthlessness, recurrent thoughts of death

Question 14

application: characteristics of an anxiety disorder - phobias

Answer 14

phobia=irrational,strong+persistent fear of and desire to avoid something
3 types of phobias:
-specific phobia - extreme fear of a specific object or situation
-agoraphobia- fear of open spaces, involving situations where help is unavailable
-social phobia- intense fear of situations with authority figure and general anxiety

Question 15

characteristics of a psychotic disorder- schizophrenia

Answer 15

schizophrenia=psychotic disorder 2+ must be present in a month:
1. delusions
2. hallucinations
3. disorganised speech
4. grossly disorganised or catatonic behaviour

Question 16

s/w of patients having to display listed characteristics for a diagnosis

Answer 16

s= clear criteria means a more reliable and accurate diagnosis, DSM could be seen as more scientific, diagnostic criteria takes account of the fact that there may be other causes for the symptoms
w= issues in how doctors assess patients through observation or relying on self report may be biased or subjective, people may not show enough symptoms to be given diagnosis so dont recieve treatment, may show symptoms of more than 1 illness so hard to make diagnosis