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Mental Health Flashcards

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1
Q

What are some historical explanations for mental health?

A

Four humours:
- the body is made up of blood, yellow bile, black bile and phlegm
- your symptoms could be related to an excess fluid (e.g. yellow bile leading to mania)

Demonic Spirits:
- possessed by an evil spirit which could be released through trepanning (drilling a hole in the head)

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2
Q

How have views of mental health changed throughout history?

A
  • before and during the 1800s seen as supernatural or imbalance in the universe (e.g. demonic spirits or planetary alignments)
  • then more somatogenic explanations, for example suggesting that mental health problems are an indication of disturbance in the brain structure - this led to a move towards more medical treatments
  • at the same time, psychogenic explanations were starting to take place, with psychoanalysis and cognitive explanations in the 20th century
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3
Q

How would you define abnormality as a statistical infrequency?

A

A trait, way of thinking or behaviour should be classified as abnormal if it is rare

Evaluation:

  • doesn’t take into account desirability of behaviour - not all rare behaviours are abnormal
  • behaviours we may consider abnormal may not be rare - e.g. 4% of the population has schizophrenia
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4
Q

How would you define abnormality as a deviation from social norms?

A

A person’s thinking or behaviour is classified as abnormal if it violates the rules about what is expected or accepted in a particular social group.

Their behaviour may:
- be incomprehensible to others
- make others uncomfortable

Evaluation:

  • can take into account behaviour desirability
  • however social norms change over time
  • definition is culturally relativist
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5
Q

How would you define abnormality as a deviation from ideal mental health?

A

Rather than define what is abnormal, we define what is normal and anything that deviates from that is considered abnormal. This includes:
- positive view of oneself
- capability for growth
- independence
- positive relationships

Evaluation:

  • focuses on positive characteristics which can be used to set goals for treatment
  • many criteria difficult to measure
  • culturally relativist
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6
Q

How would you define abnormality as the failure to function adequately?

A

Person should be considered to be abnormal if they’re unable to cope with the demands of everyday life, e.g. if they can’t hold down a job or interact meaningfully with others

Evaluation:

  • can be easily identified by others
  • easy to access
  • some are subjective
  • difficult to determine when personal distress becomes dysfunctional as sometimes it is necessary
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7
Q

What is the difference between the ICD-10 and the DSM-V?

A
  • ICD has both physical and mental disorders whilst the DSM has only mental
  • the ICD is intended to be used in any culture (was trialled in 40 countries to see if diagnoses improved) whilst the DSM is mainly used in the US (does attempt to acknowledge culture by suggesting diagnosis is more challenging when the patient’s culture is different from the clinician’s)
  • ICD: each disorder has a description of the main features and how many are needed for a diagnosis, DSM: decided whether the patient is showing symptoms of a clinical or personality disorder and their functioning is rated from 1-100
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8
Q

What were the aims of Rosenhan’s experiment?

A
  • to test the reliability and validity of the diagnostic system
  • to investigate whether a number of sane pseudopatients would be discovered
  • to complete a reliable and valid observation and report on the experiences of being a patient in a psychiatric hospital
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9
Q

What procedure did Rosenhan carry out?

A
  • 8 pseudopatients were given fake names and fake occupations to protect their identities
  • called hospitals and complained of hearing unfamiliar voices of the same sex saying “empty”, “hollow” and “thud” - all other information was completely honest
  • all symptoms of existential psychosis, of which there were no reported cases, so there was more likely to be a diagnosis of schizophrenia
  • once they were admitted they stopped showing symptoms and behaved normally
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10
Q

What evidence of powerlessness and depersonalisation can be found in the way hospital staff treated patients?

A

Powerlessness - staff were violent towards patients and abusive behaviour only stopped when another member of staff was present

Depersonalisation - despite being concerned that the staff would notice their note taking, no one ever asked what it was about; they were treated like they were invisible

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11
Q

Why did the staff act the way they did towards the patients?

A
  • product of generally held prejudices against mentally ill people
  • product of the inverse relationship between power and the amount of time spent with patients
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12
Q

What was the type 2 error in Rosenhan’s study?

A

The patients were being diagnosed with schizophrenia when they were actually perfectly healthy

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13
Q

What is the stickiness of labels?

A

The idea that someone will be prejudiced against because it is very difficult to shake the label of being mentally ill - even on release they are only “in remission”, suggesting their condition will never truly go away

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14
Q

What provided evidence of the effects of labelling in the hospital?

A
  • If a patient “went beserk” because they’d been mistreated by an attendant, the nurse who dealt with it would simply pass it off as a symptom of their condition
  • Because the hospital is so boring, patients planned days around mealtimes, which doctors saw as a symptom of their conditions when really they were just bored
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15
Q

What happened when staff at a large hospital heard about Rosenhan’s study?

A
  • they doubted the validity and said that they’d be able to spot any pseudopatients
  • Rosenhan said in the next three months he would send at least one pseudopatients and to rate each patient on a scale from 1-10 on the likelihood of them being a pseudopatient
  • 193 patients were presented
  • 41 were judged to be a pseudopatient by at least one member of staff, however none were actually sent
  • Demonstrates that the likelihood of a type one error is also high
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16
Q

Was Rosenhan’s study reliable?

A
  • Low inter rater reliability: no coding system and pseudopatients weren’t given any guidance on what to observe
  • Pseudopatients were from different backgrounds so may have interpreted behaviours differently
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17
Q

Was Rosenhan’s study valid?

A
  • High ecological validity: participants were not aware they were being observed so would behave naturally
  • High face validity: observes the accuracy of diagnosis by presenting patients
  • High criterion validity: the follow up study supported the results of the first study
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18
Q

Was Rosenhan’s study ethical?

A
  • Negative impact on pseudopatients, but protected them by using fake names
  • Telling those who questioned the pseudopatients that they were wrong may have caused them further harm through paranoia
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19
Q

Was Rosenhan’s study socially sensitive?

A
  • Reduces prejudice against people who have been diagnosed with a mental health illness but are non-symptomatic
  • Causes prejudice against people working in the mental health industry
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20
Q

How does Rosenhan’s study contribute to the individual vs. situational debate?

A

Shows that situational factors have a significant impact on diagnoses - being in the mental hospital meant that behaviour was labelled as abnormal when it was in fact “normal”

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21
Q

What is an example of a psychotic disorder and how is it diagnosed?

A

Schizophrenia
- two or more positive symptoms must be experienced for one month to be diagnosed
Positive:
- persistent hallucinations/voices giving a running commentary
- delusions of control, influence or passivity
Negative:
- social withdrawal
- significant and consistent change in overall quality of some aspects of behaviour

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22
Q

What is an example of an affective disorder and how is it diagnosed?

A

Depression
- depressed mood/loss of interest in daily activities for more than two weeks
- impaired function: social, educational, occupational
- symptoms such as: change in sleep, weight change over 5%, guilt/worthlessness, concentration and suicidality

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23
Q

What is an example of an anxiety disorder and how is it diagnosed?

A

OCD - obsessive compulsive disorder

Obsessive thoughts: ideas, images or impulses entering the mind again and again in a stereotyped form

Compulsive acts: stereotyped behaviours repeated again and again

  • both must be present on most days for two weeks to make a diagnosis
  • must be a source of distress and be unpleasantly repetitive
  • must be at least one thought or act that is still resisted unsuccessfully
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24
Q

How does the biochemical model explain depression?

A
  • the monoamine hypothesis proposes that depression is caused by low levels of a group of neurotransmitters called monoamines (including serotonin, noradrenaline and dopamine)
  • monoamines are important in regulating the function of the limbic system in the brain, which controls emotion and drives states such as appetite
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25
Q

How does the biochemical model explain schizophrenia?

A
  • revised dopamine hypothesis suggests that schizophrenia is not due to an excessive amount of dopamine, but rather an excessive amount of dopamine receptors at the postsynaptic neurone
  • therefore there is more dopamine absorbed into the next neurone and an excess in various brain pathways
26
Q

How does the biochemical model explain the positive and negative symptoms of schizophrenia?

A

Positive:
- hypofunction (too much dopamine activity) in the mesolimbic pathway (responsible for motivation, emotion and reward)

Negative:
- erratic dopamine function in the mesocortical pathway (responsible for executive function: mental control and self regulation)

27
Q

How does the brain abnormality model explain depression?

A
  • hippocampus significantly smaller in depressed patients (e.g. Sapolsky 2001: can be reduced in volume by up to 20%)
  • reduction in grey matter therefore the function of the hippocampus explains why depressed people process emotionally charged memories dysfunctionally
  • Milo et al (2001) found (using PET scans) that frontal lobes in depressive patients don’t draw on blood flow in the brain as they usually would (hypoperfusion)
28
Q

How does the brain abnormality model explain schizophrenia?

A
  • schizophrenics have enlarged ventricles which lead to reduced amount of grey matter in the brain
  • particularly in temporal lobes (explaining hallucinations) and frontal lobes (explains incoherent speech)
  • reduced overall brain size and less grey matter

Evidence:

  • Hilleke Hulshoff Pol et al. (2002) compared 159 schizophrenics to 158 ‘healthy’ people and found there can be an increase in up to 30% in ventricle size (also less grey matter)
  • meta-analysis by Sander Haijima et al. (2013) found through MRI scans of over 8000 patients brains that they were 2.6% smaller than normal
29
Q

What study did Gottesman conduct and why?

A
  • wanted to provide more convincing evidence for the genetic explanation by completing a dual mating study, examining the outcomes for offspring of parents with homotypic conditions (both the same condition)
  • looked at either one or both parents having schizophrenia or bipolar
30
Q

Where did Gottesman obtain his sample from?

A
  • 2.7 million people in Denmark born before 1997 and had identifiable parents in the Danish Civil Registration System
  • mental health status identified in the Danish Psychiatric Central Register which contains records of all patients and admissions to inpatient facilities since 1969
31
Q

What sample did Gottesman use?

A
  • 196 couples both with schizophrenia and their 270 children
  • 83 couples both with bipolar and their 146 children

For comparison:

  • 8006 w/ one w/ schizophrenia and their 13878
  • 11995 w/ one w/ bipolar and their 23152 children
32
Q

What method did Gottesman use?

A
  • quasi experiment as IV is mental health condition which already exists - DV is child’s mental health
  • secondary data used
  • findings are correlational (so cannot prove causation)
33
Q

What were the results of Gottesman’s study?

A
  • the risk of being diagnosed with schizophrenia when both parents are is 31.7 times higher than when neither parent is
  • the risk of being diagnosed with bipolar when both parents are is 51.9 times higher than when neither parent is
34
Q

What was the conclusion of Gottesman’s study?

A
  • supports previous findings but more compelling due to large sample size
  • aware of risks of data use, particularly in countries with privately funded health care, considering the historical use of such data to support the eugenics movement
  • suggests data can be used to facilitate discussion about marriage and family planning
35
Q

What do antipsychotics treat and how do they work?

A
  • schizophrenia
  • they are dopamine antagonists because they block dopamine: do this by occupying postsynaptic receptor sites, reducing activity in the postsynaptic neurone
  • reduced dopamine means less activity in the mesolimbic pathway and therefore a decrease in positive symptoms
36
Q

What are the types of antipsychotics and how are they taken?

A

First generation (typical): introduced as a tranquiliser - reduces positive symptoms but not negative symptoms

Second generation (atypical): newer and more widely used - block dopamine receptors in a more gradual way and reduce negative symptoms

  • drugs in tablet form, important to take regularly to stabilise dopamine levels otherwise will relapse
37
Q

Are antipsychotics useful?

A
  • significant pharmacotherapeutic benefits (do reduce symptoms)
  • Stefan Leucht et al. (2012) found antipsychotic medicine reduces relapse rate: 27% on neuroleptic medication relapsed, 64% on placebo relapsed
38
Q

What are the side effects of antipsychotics?

A
  • worst effects referred to as extrapyramidal - patients suffer from tremors, spasms, jerky movements or restlessness
  • can be very distressing for patients and they may need further medication to reduce them
39
Q

What is ECT for and how does it work

A
  • ECT (electroconvulsive therapy) is for depression
  • done under general anaesthesia
  • small electric currents passed through the brain, intentionally triggering a brief seizure (15-60secs)
  • typical treatment 2-3 weeks involving approx. 12 sessions
40
Q

How can ECT be evaluated?

A
  • can be used in conjunction with drug treatments and other treatments
  • side effects, most commonly memory loss - normally temporary but can still be distressing
  • evidence for effectiveness is inconclusive - Read and Bentall (2010) concluded it’s no more effective than a placebo
41
Q

What are the key principles of the behaviourist perspective?

A

Classical conditioning: learning through association

Operant conditioning: learning through reinforcement and punishment

Social learning theory: learning through role models

42
Q

How does the behaviourist model explain phobias?

A
  • phobias develop as a result of a negative experience with the object, context or activity
  • stimulus generalisation is important in this explanation, e.g. people can fear all bees not just the bee that stung them
  • if a neutral stimulus is paired with an unconditioned stimulus that causes an unconditioned response, the neutral stimulus will become conditioned to produce a conditioned response
43
Q

What study provides evidence for the behaviourist perspective?

A
  • Watson and Rayner’s study
  • classically conditioned Little Albert to fear a white rat
  • able to show that this fear was generalised to other similar objects like a white rabbit
44
Q

What is behaviour therapy?

A
  • behaviourist therapies aim to improve the condition of the sufferer by reducing the negative behaviour
  • this will in turn improve their emotional state as they unlearn negative behaviours
45
Q

What is an example of behaviour therapy?

A
  • systematic desensitisation
  • treatment for phobias which involves the gradual introduction of the feared stimulus with relaxation training at each stage
  • idea is that the person will form a new association with the feared object or situation (i.e. the conditioned response will be relaxation)
46
Q

What does the cognitive model suggest as an explanation for mental health?

A
  • concerned with thought processes, and suggests that mental illness is a consequence of disruption to normal thought processes
  • i.e. those with a particular mental illness will have notably different thought processes to those without this illness
47
Q

What is an example of the cognitive model?

A
  • Beck’s cognitive triad model of depression
  • suggests there are three main themes of dysfunctional thought that cause depression
  • negative views about oneself, the world and the future
  • theory has been extended and adapted many times
  • most psychologists believe these faulty thinking patterns are likely to begin developing during childhood during “schema development”
48
Q

What are examples of cognitive distortion?

A
  • over generalisation
  • filtering
  • catastrophisation
  • dichotomous reasoning
49
Q

What is cognitive behavioural therapy?

A
  • helps patients identify irrational and unhelpful thoughts and try to change them, based on the idea that these are the causes of negative feelings and behaviours patients experience
  • typically have one session per week with hw tasks between sessions, for 5-20 sessions
  • common feature of CBT is the introduction of positive self talk, initially through role play and then in practice
50
Q

What is an example of a variation of cognitive behavioural therapy?

A
  • Rational Emotive Therapy (Ellis)
  • helped patients identify the following…:
  • activating events that contributed to psychological disturbance
  • beliefs that stem from these activating events
  • consequences of these beliefs that are likely to affect psychological wellbeing and self esteem
51
Q

What did Ellis find about the usefulness. of rational emotive therapy?

A
  • 44% of patients receiving RET made ‘considerable’ improvements, compared to only 13-18% of patients receiving alternative therapies
52
Q

What does the psychodynamic model suggest about the cause of mental illness?

A
  • suggests mental illness s caused by unconscious memories and feelings manifesting themselves as abnormal behaviour
  • these feelings are likely to be caused by conflict between the id, ego and superego
53
Q

What were Freud’s ideas about the role of sexual trauma and fantasy?

A
  • childhood sexual abuse plays a role in almost every case of mental illness
54
Q

What is Freud’s hydraulic model?

A
  • suggests that psychic energy needs to be balanced in the same way that physical energy does
  • if psychic energy builds up as a result of trauma or an inability to express emotions, it will need to be expressed in other ways
55
Q

What does the psychodynamic model suggest about schizophrenia?

A
  • Fromm-Reichmann came up with the schizophrenic parent explanation
  • suggested that mothers that create high levels of emotional tension and secrecy in their homes, who are cold and domineering, and who set their children up in lose-lose situations, can cause scizhophrenia for their children
56
Q

What was Freud’s theory of depression?

A
  • proposed some cases of depression could be linked to the experience of the loss of a parent or rejection by a parent
  • Freud observed that being angry is an important part of grief and if the child is unable to express this, it can be turned inward, causing guilt and low self-esteem as the ego “rages against itself”
57
Q

What is psychoanalytic psychotherapy?

A
  • consists of 1-3 sessions per week for 1-5 years
  • no attempt to equip the patient with more constructive patterns of thinking or behaviour
  • explore the patient’s past and link this to their current symptoms, particularly focussing on early experiences of loss or rejection when patients have depression
  • main goal is for patients to vividly recall these experiences (abreaction) and “discharge” the associated amotion (catharsis)
  • therapist can explain feelings and how these link to their symptoms
58
Q

What study shows evidence for the effectiveness of psychoanalytic psychotherapy?

A
  • Leichsenring et al. conducted a meta analysis of studies
  • found those patients who had psychoanalytic psychotherapy showed significant improvements in symptoms and social functioning in comparison to patients receiving other forms of treatment
59
Q

What key points does Szasz make about the medical model in his article?

A
  • the medical model is dehumanising, as it ignores the suffering of person
  • mental hospitals are more like prisons to control peoples’ behaviour, depriving them of the freedom to behave as they choose
  • the medical model coerces people into receiving treatment, whether they want help or not
60
Q

Why does Szasz suggest that mental illness is a myth?

A
  • not a disease that can be scientifically proven, as there is no identifiable cause like an infection or deficiency
  • it is a way of coping
  • diagnosis is subjective, not based on scientific assessment
  • mental illness is judging the ‘bad’ behaviour of people
61
Q

What does Szasz note about the government’s role in mental illness?

A
  • governments decide what illnesses exist, control all regulation and funding
  • economic issues play a significant role in the treatment of mental illness as pharmaceuticals are highly profitable
  • however these pharmaceuticals only suppress symptoms
62
Q

How does Szasz suggest we should help people with mental illnesses?

A
  • we need to try and understand the reasons for a person’s actions by respecting, understanding and helping them
  • not by diagnosing them under a loose fitting definition

Applied Psychology (13 decks)

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