Mental Health- Historical Flashcards
Section A Paper 3
Historical
What treatment was used from 460-377 BC?
* What mental illness?
* What was the belief about the cause?
* What did treatment involve?
* How did treatment work?
Bloodletting
* Any mental illness
* Hippocrates- caused by humour imbalance
* Let out blood to rebalance 4 humours
* Made 4 humours balanced- let blood drain out
Historical
What treatment was used between 65000BC and the Middle Ages?
* What mental illness?
* What was the belief about the cause?
* What did treatment involve?
* How did treatment work?
Trepanning
* All
* Devils, demons and spirits
* 2 holes in scull, release demons by destroying part of the brain
* Demons are released through hole
What is deviation from social norms?
A person is abnormal if they don’t act the same as everyone else
Historical
What is the definition of abnormal?
Atypical/ not fitting the usual norms in society
Historical- Classification of diseases
What is the ICD-11?
An international standard diagnostic classification published by the World Health Organisation- main system outside of the US- Chapter V relevant for behavioural disorders
Historical- Classification of diseases
What is the DSM-5?
The classification of the American Psychiatric Association- main classification system in the US
Historical- Classification of diseases
Which section of the DSM-5 applies to clinical disorders?
Section 2
Historical- Classification of diseases
Give three main categories of disorder in the DSM-5?
- Depressive disorders
- Anxiety disorders
- Neurodevelopmental disorders
Historical- Rosenhan (Exp 1)
What was the aim of Rosenhan’s research?
To investigate if a group of sane people could be falsely diagnosed and admitted to psychiatric hospitals
Historical- Rosenhan (Exp 1)
What was the sample used, in terms of both confederates and actual participants, as in hospital staff?
- 8 confederates (5m, 3f) who acted as pseudo patients
- Hospital staff from across 12 different psychiatric hospitals across 5 states in 1960’s America (didn’t know about experiment)
Historical- Rosenhan (Exp 1)
What research method and design was used?
- Participant observation- pseudo patients are taking part
- Naturalistic observation- participants’ natural environment (NOT FIELD EXP- no DV manipulation)
Historical- Rosenhan (Exp 1)
Describe the pseudo patients.
- Gave false names
- Gave false occupations
- Gave false symptoms
- Gave real life histories
Historical- Rosenhan (Exp 1)
When the pseudo patient arrives at the hospital, what voices did they claim to hear?
- “empty”
- “hollow”
- “thud”
Historical- Rosenhan (Exp 1)
What did pseudo patients do once on the ward?
What were they told they’d have to do by themselves?
- Took part in ward activities
- Said they were fine when asked how they were feeling- no longer experienced symptoms
Have to get out on their own devices (discharge through concincing staff they’re better)
Historical- Rosenhan (Exp 1)
Why did pseudo patients not care about the fact they were taking notes in the open not in secret?
Staff will have thought it was nothing due to diagnosis label
Historical- Rosenhan (Exp 1)
In how many hospitals did the pseudo patients carry out an observation on behaviour of staff towards patients?
4
Historical- Rosenhan (Exp 1)- Results
How many patients were diagnosed with schizophrenia and how many manic-depression?
Why is there an issue with the manic-depression diagnosis?
11 schizophrenia, 1 manic-depression (some of the 8 patients were admitted more than once)
Highlights how there is an issue with diagnosis methods as all were posing as schizophrenia
Historical- Rosenhan (Exp 1)- Results
How did the nurses report the pseudo’s behaviour?
- Reported as showing ‘no abnormal indications’, but interpreted data in context of their diagnosis
Historical- Rosenhan (Exp 1)- Results
What 2 words did Rosenhan use to describe the hospitalisation of the pseudo patients?
- “depersonalisation”
- “powerlessness”
Historical- Rosenhan (Exp 1)- Results
Why were the experiences noted to be unethical?
- Medical records were open for anyone to read
- Toilets have no doors
- Staff would be brutal to other patients in full view of others
Historical- Rosenhan (Exp 1)- Results
Whst type of error was Experiment 1?
1
Historical- Rosenhan (Exp 2)
What was the aim of Exp 2’s research?
To investigate if the overcautious diagnosis in study 1 would be impacted by the knowledge of mistaken diagnosis
Historical- Rosenhan (Exp 2)
What was the sample for this part of the research?
The staff in just one of the 12 hospitals- they were told last studies results and struggled to believe it
Historical- Rosenhan (Exp 2)
What research method was used to collect quantitative data?
Questionnaire
Historical- Rosenhan (Exp 2)
What were the staff told regarding admission of pseudo patients?
They’d admit one or more pseudo patients in next three months
Historical- Rosenhan (Exp 2)
Were the newly admitted patients pseudo patients or real patients?
Atcual patients with real mental health disorders
Deception- Unethical!
Historical- Rosenhan (Exp 2)- Results
How many patients did the staff incorrectly rate as sane?
83/ 193
Type 2 error- false negative
Historical- Rosenhan (Exp 2)- Results
How much of the regular intake of patients were judged to be pseudo?
Which reliability does this reduce?
10% of regular patient intake- judged by psychiatrist and another staff member
Inter-rater
Historical- Rosenhan (Exp 2)- Results
What kind of error was experiment 2?
Type 2 error
Historical- Rosenhan
What did Rosenhan’s work conclude about psychiatrists and diagnosis?
They cannot reliably tell the difference between those who are sane and those who aren’t
Historical- Rosenhan
What did the first experiment illustrate as opposed to the second?
- Failure to detect sanity
- Failure to detect insanity
Historical- Rosenhan
What did Rosenhan conclude about the labelling of ‘insane’?
Once it has been given, all behaviour is contextualised in light of the label- leads to powerlessness and depersonalisation
Characteristics of Disorders
What’s the definition of an affective disorder?
Category of mental health which focuses on abnormal behaviours regarding emotional control
Mood disorders
Characteristics of Disorders
According to the DSM-5, give three symptoms that must/ may be present to diagnose depression.
- Depressed mood most of the day nearly every day
- Disinterest/ reduced pleasure in all or almost all daily activities, nearly every day
- Insomnia or hypersomnia nearly every day/ night
Characteristics of Disorders
What is the definition of an anxiety disorder?
Category of mental illness that causes constant or sudden feelings of fear, restlessness and worry
Characteristics of Disorders
According to the DSM-5, give three symptoms that must/ may be present to diagnose phobias.
- Persistent fear that is unreasonable, cued by the presence of a certain object/ situation
- The phobic situation is avoided, or else endured with inence anxiety and distress
- The patient knows that the fear is excessive/ unreasonable (may be absent in children)
Characteristics of Disorders
What is the definition of psychotic disorders?
A group of serious illnesses that affect the mind- make it hard for someone to make a judgement or think clearly
Characteristics of Disorders
According to the DSM-5, give three symptoms that must/ may be present to diagnose a psychotic disorder.
- Delusions
- Hallucinations (visual and/ or auditory)
- Disorganised or unresponsive behaviour
Disturbance must persist for six months with no other causes e.g. substances
