Mental Health - Historical context of Mental Health

Question 1

Four Humours (Background)

Answer 1

• Hippocrates categorised mental illness into 4 categories: epilepsy, mania, melancholia and brain fever
• Theorised that mental disorders were caused by an imbalance in the 4 humours:
  
  • Yellow bile: impulsive, overambitious and restlessness
  • Blood: courageous, hopeful and restless; imbalance causes epilepsy
  • Phlegm: calm, cool and unemotional; imbalance causes mania
  • Black bile: despondent and gloomy; depression/melancholia

Treatments included blood letting, taking laxatives/making someone throw up or have diarrhoea and going on a particular diet.

Question 1

Trapanning (Background)

Answer 1

• Mental illness was thought to be evil spirits trapped inside an individual’s head
• Possession of evil spirits were believed to be a punishment form from the gods for misdeeds and wrongdoings
• Trapanning involved drilling holes in people’s heads to release the evil spirits
• Was used up until the 1800s to treat depression, schizophrenia and mania - drilled holes in specific parts of the brain to destroy the ‘evil spirits’

Question 2

Definitions of Abnormality - Statistical Infrequency (Background)

Answer 2

• Any behaviour which is shown less often than the normal amount for that society
• Possible to gather data in a numeric form and derive a mean (average value) - abnormal results lie 3+ standard deviations from the mean
• E.g. someone with IQ lower than 70 is considered ‘abnormal’

Question 3

Strengths of Statistical Infrequency (Background)

Answer 3

• Real life application - useful to clinical diagnosis
• Quantitative - easy to compare conditions to one another so easy to see outliers

Question 4

Weaknesses of Statistical Infrequency (Background)

Answer 4

• Unusual characteristics could be positive e.g. high IQ
• Labelling does not always benefit the individual and may affect them in a negative way; self-fulfilling prophecy

Question 5

Definitions of Abnormality - Deviation from social norms (Background)

Answer 5

• Social norms are unwritten rules which govern behaviour in a given social context
• If a person is not following these norms, they could be considered as demonstrating abnormal behaviour e.g. wearing white to a funeral

Question 6

Strengths - Deviation from social norms (Background)

Answer 6

• Takes into account social dimension + cultural relativism; one behaviour which is normal in one context may be abnormal in another (same goes for time period)
• Tries to avoid ethnocentrism

Question 7

Weaknesses - Deviation from social norms (Background)

Answer 7

• Difficult to define what a ‘cultural context’ is - cultures have subcultures within them
• Susceptible to abuse Szasz - labelling of non-conformists as people with mental illness
• Does’t provide an objective definition of abnormality

Question 8

Other definitions of abnormality

Answer 8

• Failure to function adequately - behaviour is maladaptive if it inteferes with an individual’s ability to lead a normal life
• Deviation from ideal mental health - Jahoda makes a criteria of ideal mental health and if anyone has 1 deviation they are mentally ill e.g. not having high self-esteem or having no self discipline or independence

Question 9

International Classification of Disorders (ICD-11) (Background)

Answer 9

• Covers all illnesses with a section on psychological disorders, and is used throughout the world
• Produced by the World Health Organisation (WHO)

Question 10

Diagnostic and Statistic Manual of Mental Disorders (DSM-5) (Background)

Answer 10

• Only concerned w psychological disorders and mostly used in USA
• Multi-axial system - looks at all of the features and categories first and builds a picture of how the person copes and engages with the world around them
• Each diagnostic listing contains detailed information regarding the specific criteria required for a diagnosis

Question 11

Strengths of Categorisation Manuals (Background)

Answer 11

• Helps establish a reliable way to categorise and diagnose behaviours
• Helps direct the most appropriate treatment for the individual
• Constantly being updated to add/remove relevant/irrelevant disorders and has more recently been trying to reduce cultural bias

Question 12

Weaknesses of Categorisation Manuals (Background)

Answer 12

• Highly subjective - professionals may diagnose people differently in spite of the criteria
• Requires self report from individuals who may not perceive their behaviour as abnormal of dysfunctional
• Significant overlap between disorders e.g. loss of pleasure in activities is a factor in both schizophrenia and major depressive disorder
• Ignores biological symptoms as only focuses on behavioural symptoms

Question 13

Anxiety disorders (Application)

Answer 13

• A cluster of mental disorders characterised by significant and uncontrollable feelings of anxiety and fear
• This leads to a person’s social, occupational and personal functions being significantly impaired

Question 14

Anxiety disorder - Phobias (Application)

Answer 14

DSM describes it as:
- Unreasonable excessive, persistent fear
- Upon seeing the phobic stimulus prompts an immediate anxiety response
- Leads to extreme distress, anticipation and avoidance of the phobic stimulus; life-limiting
- Must have lasted for at least 6 months to be diagnosed
- Not caused by another disorder

Question 15

Psychotic disorders (Application)

Answer 15

• Involves loss of contact with reality and causes abnormal thinking and perceptions
• Has similar symptoms across disorders

Question 16

Psychotic disorder - Schizophrenia (Application)

Answer 16

First rank symptoms (must have had in 6 month period):
- Delusions
- Hallucinations (sensory)

Positive symptoms (things you didn’t have before):
- Hallucinations + Delusions
- Disorganised speech; ‘word salad’
- Psychomotor disturbances e.g. rocking back and forth, twitches and repetitive behaviours

Negative symptoms (things scz takes away):
- Avolition - lack of desire/motivation; in which a person becomes totally apathetic
- Alogia - loss of emotion and speech
- Catatonia - staying in a position for hours/days on end
- Social withdrawal

Question 17

Affective Disorders (Application)

Answer 17

• Affects mood and ranges from mild to severe
• Typically individuals may experience marked feelings of sadness, emptiness or irritability
• What sets these orders apart is the damaging impact on the individual’s capacity to function

Question 18

Affective Disorder - Major Depressive Disorder (Application)

Answer 18

First rank symptoms (must be present during same 2 week period nearly every day):
- Depressed mood for most of/all the day
- Loss of interest or pleasure in most/all activities

Other symptoms:
- Significant weight appetite loss/gain
- Frequent insomnia/hypersomnia
- Inability to relax or sit still or excessive lethargy
- Excessive feelings of worthlessness or guilt
- Recurrent thoughts of death, suicidal ideation, suicide attempts or self harm

Can reoccur - risk of recurrence diminishes over time spent in remission.