Mental Health: Alternatives to the Medical Model Flashcards

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1
Q

Biological approach (medical model)

Type of disorder?

A

Psychotic disorder.
-> A mental state often described as involving a “loss of contact with reality”).

Example:
-> Schizophrenia
-> Bipolar / unipolar disorder

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2
Q

Biological approach (medical model)

DSM-V symptoms

A

Example: Schizophrenia.

Two or more of the following, each present for a significant portion of time during a one-month period:

1- Characteristic symptoms:
* Delusions
* Hallucinations
* Disorganised speech
* Grossly disorganised or catatonic behaviour.
* Negative symptoms.

2- Plus:
* Social occupational dysfunction: For a significant portion of time since the onset of the disturbance one or more major area of functioning.
* Duration: continuous symptoms for 6 months, and within this 6-month period – 1 month of active phase symptom.
* The disturbance is not due to a medical problem or drug abuse.

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3
Q

Biological approach (medical model)

Studies to support the approach?

A

Key study:
* Gottesman et al (2010) -> Investigates the importance of genetic influence on offspring where both parents have been admitted with a severe psychiatric disorder.
- Used secondary research (medical records / office for national statistics).
- Sample: Population of Denmark.
- Diagnosed using ICD-8 & 10 (concurrent validity).
- Mental disorders studied: schizophrenia, bipolar / unipolar disorder.
- Found that there was a higher probability of offspring developing the same mental disorder as their parents if both their parents had previously been diagnosed (27.3%). (As opposed to one (7%) / none (0.85%)).

Other studies:
* Gottesman and Shields (1976) -> Twin study.
Showed that when looking at the development of schizophrenia, twin studies consistently find higher concordance rates in monozygotic twins than dizygotic twins. This suggests evidence of a genetic predisposition. cause of schizophrenia (but not 100% so must be partly due to environment).

  • Brown et al. -> Brain abnormality.
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4
Q

Biological approach (medical model)

How does it explain mental illness?

A

That mental illness is due to 3 main factors:

1) Genetics
Offspring inherit genes from parents which means they develop the same mental disorder.

2) Biochemical
Due to neurotransmitters e.g., dopamine, serotonin, and noradrenaline.

3) Brain abnormality

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5
Q

Biological approach (medical model)

Treatments?

A

Assumes mental illness is due to biochemical explanation:

1) Drugs (chemotherapy)
E.g., schizophrenia = antipsychotics.

2) ECT (Electro-Convulsive Therapy)

3) Psychosurgery (brain surgery)

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6
Q

Behaviourist approach

Type of disorder?

A

Anxiety disorder.
-> A continuous feeling of fear and anxiety, which may be triggered by something that may seem trivial / irrational to others.

->Can be experienced on several levels: emotionally, cognitively, physiologically, and behaviourally.

E.g., phobia.

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7
Q

Behaviourist approach

DSM-V Symptoms?

A

E.g., phobia:

  • Marked an persistent fear that is excessive or unreasonable.
  • Exposure to phobic stimulus provokes immediate anxiety response.
  • The person recognises the fear as excessive.
  • The phobic situation is avoided.
  • The fear is out of proportion to the actual danger posed by the specific object or situation.
  • The phobia disrupts the person’s normal life.
  • The phobia has lasted more than 6 months in people under 18 years of age.
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8
Q

Behaviourist approach

Studies to support the approach?

A

Key study:
* Watson & Raynor (1920) Conditioned emotional reactions (Little Albert). -> Classical conditioning.

  • Aim:
    To see if it is possible to induce fear of a previously un-feared object through classical conditioning and to see if the fear will be transferred to other, similar objects.
  • Method:
    Case study conducted under controlled laboratory conditions.
  • Ps: Little Albert.
  • Procedure:
    Little Albert was shown items which he should not fear e.g., white rat, mask, rabbit etc. Then, once he was given them again there would be a loud noise. This association with the e.g., white rate with the loud noise made Little Albert fear the white rat (developed a phobia of rats).
  • Learning through association.

Other studies:

  • Bandura
    -> Social learning theory.
    Where aggression was learnt through the behaviour of models. This links to mental illness because e.g., if a parent displayed symptoms for a mental disorder, their child could learn their behaviour and develop it as well.
  • Chaney
    -> Classical and operant conditioning.
  • Ivan Pavlov (1849 – 1936)
    = dogs -> Classical conditioning.
    Shows that animals can learn to associate a conditioned stimulus with an unconditioned stimulus (rang a bell before the dog was fed).
  • Skinner (rats)
    -> Operant conditioning.
  • Rats given positive reinforcement (behaviour had no consequence. If lever pressed the rat gets food).
  • Rats given negative reinforcement (floor is electrified and lever turns off the current).
  • Rats given punishment (instead of given treat for pushing lever, given an electric shock).
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9
Q

Behaviourist approach

How is mental illness explained?

A

That mental illness is due to our environment / experiences.

  • Tabala Rasa: “We are born blank slates”.
  • This means we can ‘unlearn’ mental disorders e.g., phobia (anxiety disorder).
    Can unlearn mental disorder e.g., phobia using:

1) Operant conditioning (Positive / negative reinforcement / punishment).

2) Classical conditioning -> e.g., desensitisation (exposure to e.g., phobia to unlearn fear / behaviour).

3) Social learning theory -> learn through observing behaviour of (role) models. Means we can unlearn / relearn behaviour through observing ‘positive’ models (e.g., people without mental disorder / ‘normal’ / desired behaviour).

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10
Q

Cognitive approach

Type of disorder?

A

Affective disorder.
-> Marked by a disturbance of mood or emotions, which prevents the individual from leading a ‘normal’ life.

E.g., depression.

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11
Q

Cognitive approach

DSM-V symptoms?

A

E.g., major depressive disorder.

Five or more of the following symptoms during the same 2-week period.

  • Depressed mood most of the day (e.g.,
    sad, empty or hopeless).
  • Markedly diminished interest in most
    activities.
  • Significant weight loss.
  • Insomnia most nights.
  • Fidgeting or lethargy.
  • Tiredness.
  • Feeling of worthlessness or guilt.
  • Diminished ability to concentrate.
  • Recurrent thoughts of death.
  • These symptoms are not caused by medication, or situations they are enough to hinder the person from important day-to-day activities / life.
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12
Q

Cognitive approach

Studies to support the approach?

A

Key study:
* Aaron Beck
- ABC cognitive model of depression:
A = Activating event
B = Belief
C = Consequence.

  • Negative cognitive triad:
    1) Defective / inadequate.
    2) All experiences result in defeats /
    failures.
    3) Future is hopeless.
  • Beck et al (1974)
  • Aim: To understand cognitive
    distortions in patients with depression.
  • Interviews with patients undergoing
    therapy for depression.
  • Self-report.
  • Findings: Depressed patients
    showed e.g., low self-esteem, self-
    blame, desire to escape etc.
  • Conclusion: Even in mild depression, patients have cognitive distortions that deviate from realistic and logical thinking. Distortions only related to depression and not other areas.

Other studies:

  • Loftus & Palmer
    -> eyewitness testimony.
  • Looked at how the critical verb affects estimated speed. (+ leading questions – saw glass / not).
  • Links to mental health: perception and memory can be altered depending on people / their phrasing.
  • **Grant et al. **
    -> context dependent memory
  • Memory is better when in the same environment as learnt the information trying to remember.
  • Links to mental health: shows that people’s perceptions can be affected by context.
  • Morray (1962)
    -> auditory attention.
  • Simon & Chabris (1999)
    -> visual attention.
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13
Q

Cognitive approach

How is mental illness explained?

A

**That mental illness is due to the way people think. **
(Faulty thinking pattern)

E.g., depression -> negative interpretation / processing of situation / comments.

  • “Our brains are like a computer”.
  • They ‘input’, ‘process’, and ‘output’.
  • Cognitive-Behavioural Therapy (CBT).
    -> a type of talk therapy that has been shown to be effective in treating depression.
  • CBT helps people learn how to identify negative patterns in their thoughts and behaviours that contribute to their depression.
  • The therapist works with the individual to challenge and change these negative patterns and develop more positive ways of thinking and behaving.
  • Cognitive Therapy (CT)
  • Similar to CBT, but it primarily focusses on thoughts without incorporating behavioural interventions etc.
  • It specifically emphasises identifying and challenging negative or distorted thoughts that contribute to emotion distress.
  • It targets specific cognitive processes and aims to replace negative thinking patterns with more balanced and realistic thoughts.
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14
Q

Humanistic approach

Type of disorder?

A

Anxiety (e.g., phobia) and affective disorders (e.g., depression).

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15
Q

Humanistic approach

DSM-V symptoms?

A

**Anxiety disorder: **
E.g., phobia:
* Marked an persistent fear that is excessive or unreasonable.
* Exposure to phobic stimulus provokes immediate anxiety response.
* The person recognises the fear as excessive.
* The phobic situation is avoided.
* The fear is out of proportion to the actual danger posed by the specific object or situation.
* The phobia disrupts the person’s normal life.
The phobia has lasted more than 6 months in people under 18 years of age.

Affective disorder:
E.g., major depressive disorder.

Five or more of the following symptoms during the same 2-week period:
* Depressed mood most of the day (e.g., sad, empty or hopeless).
* Markedly diminished interest in most activities.
* Significant weight loss.
* Insomnia most nights.
* Fidgeting or lethargy.
* Tiredness.
* Feeling of worthlessness or guilt.
* Diminished ability to concentrate.
* Recurrent thoughts of death.
These symptoms are not caused by medication, or situations they are enough to hinder the person from important day-to-day activities / life.

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16
Q

Humanistic approach

Studies to support the approach?

A

There are two founders of the humanistic perspective: **
* Abraham Maslow
* Carl Rodgers **
They both maintain that we are born with an innate propensity to grow and this motivates us to be the ‘best’ we can be in this life time.

**Carl Rodgers: **
- Suggests that we are fundamentally an organism and like any other organisms we seek out what provides the best opportunity for our growth.
* Rodger’s theory was concerned with the self-image that people create for themselves (their actual self) and how this differs from their ideal self (the concept of self, moulded by others).
* Basis of ideal self: Our innate propensity to self-actualise which is present from birth can be interrupted / thwarted by the demands society place on us.
Fully functioning person = Someone whose mental set-up is such that they are in a position to fulfil their human potential.

**Abraham Maslow: **
Our motivation to grow is influenced by two sets of motivational forces:
- Satisfying basic physical and psychological needs.
- Those that promote the person’s self-actualisation.

*Self-actualisation *= ‘becoming everything that one is capable of becoming’.

  • Maslow developed the “hierarchy of needs” as a motivational model underpinning ‘health’.
  • The hierarchy works on the basis of homeostasis in so far as when one need is met then there is a natural motivation to ascent to the next stage; only when one stage is met that the next is pursued.
  • Esteem needs commence with the need to be respected by others, thereafter the need becomes focused on self-esteem.
  • Hierarchical needs / levels (bottom to top): physiological needs -> safety needs -> belonging needs -> esteem needs -> self-actualisation.

Maslow identified a number of factors that described self-actualisers including:
- The accept themselves, together with all their flaws.
- They are motivated by growth, not by the satisfaction of needs.
- They share deep relationships with a few, but also feel identification and affection towards to entire human race
- They do not take their blessings for granted

17
Q

Humanistic approach

How is mental illness explained?

A

Believes that every unique individual has freewill and are self-determined to aspire to our full potential.

(Humanistic psychology takes a more optimistic stance, focusing on what we can be in the here and now rather than what happened in the past).