Mental Health Psychology

Question 1

What is Demonic Possession?

Answer 1

Belief that everyone and everything has a soul, and that evil spirits had taken possession of an individual and controlled their behaviour.

Trepanning to give the evil spirit an exit from the skull

Question 2

What is Animalism?

Answer 2

The view that mentally ill people should be treated like an animal. Madness was believed to be the person losing the capacity of reason.

The treatment was to restore reason and it was believed that fear was the emotion that was best suited to restoring a disordered mind.

Other treatment was given such as shaving scalps, bleeding, blistering and making them sick

Question 3

What is Humourism?

Answer 3

Humourism was the idea that the body was made up of four humours: Black bile, Yellow bile, phlegm and blood. The imbalance of the four humans was thought to cause madness and could be cured from rebalancing them.

Treatment involved bloodletting, laxatives and purgatives

Question 4

What is Moral Treatment?

Answer 4

Panel suggested the new, non-violent approach to the case of mental patients. He argued for the humane treatment of mental patients, including a friendly interaction between Doctor and patient. His treatment as marked by Goodwill.

Pinel rejected the popular idea of demonic possession being the cause of mental illness and was one of the first to believe that mental disorders can be caused by psychological or social stress, cognitional conditions or physiological injury.

Question 5

What is the aim of Rosenhan and Seligman?

Answer 5

Explore four different ways of defining abnormality.

Question 6

What is the first way of defining abnormality in Rosenhan and Seligman?

Answer 6

Statistical infrequency:

Any behaviour that is shown less often than the normal amount for that society can be regarded as abnormal, simply because it is not the (Statistical) norm for that society. It is abnormal in the sense of being rare.

However just because a behaviour is rare, doesn’t mean that it is abnormal (e.g olympic athletes or NBA basketballers)

Question 7

What is the second way of defining abnormality in Rosenhan and Seligman?

Answer 7

Deviation from social norms:

Another way in which someone can be regarded as abnormal is if they go against behaviours that are deemed by the society they live in to be ‘normal’ and ‘acceptable’.

However, each culture will vary in what these things are seen as normal behaviours and some people may choose to dress differently out of choice rather than any mental health issue

Question 8

What is the third way of defining abnormality in Rosenhan and Seligman?

Answer 8

Failure to function adequately

Defined living a normal life adequately as being able to hold down a job, maintain a relationship, look after themselves and interact in society effectively.

However, sometimes ability to function in this was may be a result of other factors (like lack of education) and people don’t always look after themselves such as smoking or drinking but this is not a sign of mental illness.

Question 9

What is the fourth way of defining abnormality in Rosenhan and Seligman?

Answer 9

Deviation from ideal mental health:

Ideal mental health: positive self-image, being capable of growth and development, having independent thoughts and actions, having accurate perception of reality, being able to cope with demands and problems maintaining positive relationships.

Question 10

What is abnormality?

Answer 10

Use Rosenhan and Seligman to define abnormality

Question 11

What is the DSM?

Answer 11

DSM-5 categorises dysfunctional behaviour in several noteworthy ways:

-It places them in chronological lifespan order, in accordance with when within a person’s life the disorder is most likely to occur.

-Neorodevelopmental disorders (e.g ADHD ; ASD) come first whereas neurocognitive disorders (e.g Alzheimers) come towards the end.

It also clusters disorders together to mirror clinical reality:

-The internalising disorders are placed together ( i.e such as depression and anxiety where the distress is mainly caused by the individual)

-The externalising disorders are placed together (e.g conduct and substance-abuse disorders which are associated with behaviours that cause harm to others)

The dysfunctional behaviours are organised into 22 categories:

-Like obsessive, compulsive and related disorders (Hoarding disorder and trichotillomania) .

-Feeding disorders and eating disorders.

-Sleep wake, disorders.

For each disorder, the DSM-5 includes details on the following:

-Diagnostic criteria, gender related diagnostic issues, culture related diagnostic issues.

Question 12

What are the characteristics of a psychotic disorder?

Answer 12

1. Delusions (Disturbances of thought involving self beliefs)

2.Hallucinations (perceptual disturbances such as hearing internal voices)

3.Disorganised speech

4.Groslly disorganised or catatonic behaviour

5.Negative symptoms such as diminished emotional expression (flattened affect, reduction in willingness to talk to other, reduced motivation to do anything)

Level of functioning should be below that prior to the onset of the symptoms. The disturbances should persist for at least 6 months, even if at minor levels, and there should be no other causes

Question 13

What are the characteristics of an affective disorder?

Answer 13

1. Depressed mood most of the day, nearly everyday.

2.Markedly diminished interest or pleasure in all activities most of the day or nearly everyday

3.Body weight loss of more than 5% not due to diet or change in appetite.

4. Insomniac or excessive sleep nearly everyday.

5.Restlessness or less activity nearly everyday.

6.Fatigue or loss of energy nearly everyday

7.Feelings of worthlessness or inappropriate excessive guilt nearly everyday

8.Lack of ability to think, or concentrate or make decisions nearly everyday

9.Recurrent thoughts of death or suicide, or suicide attempt

Question 14

What are the characteristics of an anxiety disorder?

Answer 14

A phobia is a strong persistent and irrational fear of, desire to avoid, a particular object, activity or situation.

-Specific phobia- An extreme fear of a specific object

-Agoraphobia- Defined as a fear of open spaces, but it typically involves the fear of being in situations from which escape may be difficult or help unavailable

-Social Phobia- An intense and excessive fear of being in situations in which one is exposed to the possible scrutiny of others. It is characterised by fear of acting in a way that will be humiliating or embarrassing to the self or others. Social phobia includes fear of public speaking, fear of interacting with an authority figure, and a general anxiety in most social situations

Majority of people that have agoraphobia are female. Social phobia arises during adolescence, Agoraphobia during early adulthood. Specific phobias occur during childhood or at any time

Question 15

What is the biochemical explanation of depression?

Answer 15

The biochemical explanation of depression is that it could be caused by a lack of serotonin. It is suggested that what is happening is that the body is not responding in the appropriate way to the stimulus it receives because there is too little serotonin in the nervous system to transmit these messages.

(BELOW IS JUST FOR UNDERSTANDING)
It has long been held that depression could be related to low levels of serotonin within the nervous system

Serotonin is a neurotransmitter. When a sense is stimulated, a message will be sent along the nervous system. The message will go from one nerve cell to another until It reaches appropriate area in the central nervous system.

The nervous system is made up of thousands of nerve cells. These nerve cells are not physically connected to each other. Instead there are synaptic clefts between nerve cells and these gaps need to be bridged for a message to pass from one pre-synaptic nerve cell to another post-synaptic nerve cell.

This is where neurotransmitters like serotonin come in. They aer chemicals in the brain that carry electrical signals from one nerve cell to another.

However, if the levels of serotonin are low then the serotonin molecules may be absorbed back into pre-synaptic nerve cell too soon (to await further simulation). This would mean that the message may not get passed effectively across the map.

Question 16

What is the biochemical explanation of schizophrenia?

Answer 16

It is suggested that schizophrenia could be related to high levels of dopamine within the nervous system, with this causing an overload of dopamine to reach post-synaptic nerve cells

Dopamine is another neurotransmitter

Question 17

What is the aim of Gottesman?

Answer 17

To investigate in a large sample the probability of a child being diagnosed with a mental disorder if either or both of their parents had this disorder.

Question 18

What is the sample of Gottesman?

Answer 18

Anyone in Denmark aged between 10 years and 52 years in January 2007 and with a clear link to their biological parents. This means that a sample of almost 2.7 million people and their parents are being stuided

Question 19

What is the procedure of Gottesman?

Answer 19

Using data from the Psychiatric Central Register, Gottesman et al identified four groups of people:

-Both parents admitted to a psychiatric hospital with diagnosis of schizophrenia, bipolar disorder, or depression

-One parent admitted to a psychiatric hospital with diagnosis of schizophrenia, bipolar disorder, or depression

-Neither parent admitted with a diagnosis of disorder

-The general public (with no data available on whether parents were admitted or not.

Question 20

What are the findings of Gottesman?

Answer 20

Where both parents were admitted with the disorder 27.3% had schizophrenia and 24.9% had bipolar.

Where one parent was admitted with the disorder 7% had schizophrenia and 4.4% had bipolar

Where neither parent had been admitted, 0,86% had schizophrenia and 0.48% had bipolar

General population admitted with the disorder had 1.12% schizophrenia and 0.63% bipolar

There also seemed to be some genetic overlap between schizophrenia and bipolar (if both parents had schizophrenia then 10.89% of offspring would be admitted with bipolar)

If both parent admitted to a psychiatric hospital then there was an increase in the likelihood of being admitted with any other disorder (if both parents had schizophrenia, 67.5% of people were admitted if neither parent had been admitted then 11.9% would be.)

At age 52, very few people are receiving a fresh diagnosis of schizophrenia; however, at the same age, fresh diagnoses of bipolar disorders were still being made.

Question 21

What are the conclusions of Gottesman?

Answer 21

-Where both parents have been admitted to psychiatric hospital with schizophrenia or bipolar disorder, their offspring are at super high risk of being admitted with the disorder themselves

Question 22

What are SSRIs?

Answer 22

Drug therapies aim to restore normal levels of neurotransmitter action, One of the most well known forms of drug treatment are Selective Serotonin Reuptake Inhibitors.

SSRIs work by blocking the reuptake of serotonin by the presynaptic neuron, This results on a greater amount of serotonin within the synapse.

With more serotonin in the synapse, this increases the likelihood of sufficient serotonin reaching the post synaptic receptor sites and triggering an electrical impulse to continue down the neuronal pathway.

SSRIs are used to treat both depression and increasingly anxiety.

Question 23

What is the genetic explanation of mental illness?

Answer 23

Genetics from parents

Evolutionary theory

Question 24

What is brain abnormality as an explanation of mental illness

Answer 24

-Brain abnormality explanations of shizophrenia

-Brain abnormality is explanations of depression

Question 25

What is brain simulation?

Answer 25

Electro-Convulsive Therapy (ECT) is where a patient has electrodes placed on their temples: an electric shock is then passed into their brain. The aim is to trigger an epileptic seizure in an attempt to ‘jump-start’ the entire brain and relieve the symptoms of a mental health disorder such as sever depression or psychotic episode. It is administered with the patient under anaesthetics

Transcranial magnetic simulation is where an electromagnetic coil is held against the patients head near the forehead and an electric current creates a magnetic pulse that travels through the skull. TMS is used as a treatment for depression and is targeted at the left prefrontal cortex, with the aim being to create small electrical currents in the brain that spread to underlying deeper areas of the brain involved in mood regulation and to normalise neural networks. Patients remains alert and awake during treatment

Question 26

What is the behaviourist explanation of mental illness?

Answer 26

Classical conditioning explanation of phobias

Operant conditioning explanation of phobias

Social Learning Theory explanation of phobias

Question 27

What does Szasz believe?

Answer 27

Szasz published an essay titled ‘The Myth of Mental ilness’. in these he challenged the medical model of mental illness which was becoming popular at the time.

Overall he believed that the drive to medicalise and politicise the US mental health system has taken credibility away from alternatives to the medical model. The politicisation of mental illness has occurred as it is the holders of political power who have settled the question what is mental illness and they have decreed that mental illness is just like physical illness. It has been medicalised in the sense that texts such as diagnostic and statistical manual led to medical illness being subject to diagnosis and treatment.

Szasz believed that mental illness is a metaphor. In his view, any mental illness found to have a physical cause were never actually mental illnesses but, instead, undiagnosed physical illnesses.

He challenges the insanity defence used by D in courts- he believes that assuming all people are inherently good, and that bad actions only occur due to mental illness, has implications for human freedom. By accepting this kind of argument, psychiatry and society deny people both the responsibility for wrong-doing and also liberty from oppression by the mental health system.

Szasz argue that psychiatrists have incredible power; they alone are qualified to categories, label and treat a person whom society deems as disturbed.

Question 28

What are the conclusions of Szasz?

Answer 28

1. The medicalisation and politicisation of psychiatry over the past 50 years has led to a dehumanised model of care

2.Mental illness should be regard as a metaphor; a fiction

3.The moral legitimacy of psychiatry should be rejected as it involves violating human liberty.

Question 29

What is Systematic Desensitisation (as a behaviourist treatment of anxiety disorders) ?

Answer 29

This is a process that teaches a person to gradually confront their fear, it is carried out in stages and the patient practices relaxation techniques at each stage to calm themselves down after an anxiety provoking stimulus is introduced.

patients build a hierarchy of the stimulus which cause them anxiety, form the least fearful to the most fearful.

Patient is taught deep muscle relaxation or to imagine themselves somewhere pleasant and relaxing for them.

Therapist takes patient step by step though their hierarchy of fear. Relaxation tech is used at each stage until not anxious before moving onto the next thing.

The patient can apply their newly learnt responses that their phobia has been removed.

Question 30

What is Flooding (as a behaviourist treatment of anxiety disorders) ?

Answer 30

one way to make the treatment quicker is by presenting the feared object directly, The immediate fear response caused by adrenaline is not sustainable and Will eventually calm down by itself.

The feeling of calm can then be associated with the feared object.

However this can cause panic and reinforcement of phobia rather than extinguish it, especially if the person is allowed to leave the situation before their adrenaline levels have naturally reduced.

PATIENTS CONSENT IS ALWAYS GAINED BEFORE DOING THIS.

Question 31

What is the aim of Rosenhan?

Answer 31

To see if mental hospitals in the USA in the early 1970s could tell the sane from the insane

Question 32

What does study 1 include in Rosenhan?

Answer 32

Study 1 involved 8 sane people phoning up for an appointment at 12 different mental hospitals.

When they arrived at admissions, they all reported the same symptoms of hearing an unfamiliar voice of the same sex saying, ‘empty’, ‘hollow’, and ‘thud’. They all gave false names.

On all occasions, the pseudo patients were admitted

They remained in hospital for 7 to 52 days (average 19 days)

When they were discharged, it was with a diagnosis of schizophrenia ‘in remission’.

Although their sanity was not detected by staff 35 out of 118 patients voiced their suspicions

While in hospital, their normal behaviours were misinterpreted (e.g queuing up early for lunch were described by a psychiatrist as displaying the oral acquisitive behaviour that might be expected of someone with schizophrenia)

Attendants spent only 11.3% of their shifts outside ‘the cage’ (i.e their ward office)

Question 33

What was the experiment within study 1 Rosenhan?

Answer 33

In 4 of the hospitals, the pseudo qateinets approached a staff member with a simple polite request such as ‘pardon me, Mr/Mrs/Dr X, could you tell me when I will be presented at the staff meeting?

They recored how staff responded to this request (i.e if they moved on with head averted, made eye contact, paused and chats, or stops and talks)

A comparison study was done at Stanford University, with a young female approaching a member of faculty who looked busy and then asking them 6 questions, including ‘Pardon me, could you direct me to Encina Hall?’ and ‘How does one apply for admissions to the college?’

Another comparison study was done at a University medical centre, with a young female saying either ‘Im looking for a psychiatrist’ or ‘I’m looking for an internist’

Question 34

What are the findings from the experiment within study 1 Rosenhan?

Answer 34

At the psychiatric hospital:
-71% psychiatrists moved on with head averted, 23% made eye contact, 2% paused and chatted, 4% stopped and talked and there were 185 attempts

-88% of nurses and attendants moved on with their head averted 10% made eye contact, 2% paused and chatted and 0.5% stopped and talked and there were 1283 attempts.

At the university:

100% of the faculty stopped and talked and there were 14 attempts

At the university medical centre:

people who were asked ‘looking for a psychiatrist ‘ 11% made eye contact, 11% pauses and chats and 78% stopped and talked and there were 18 attempts

likewise for those asked ‘looking for an internist’, 100% stopped and talked and there were 15 attempts

Question 35

What does study 2 in Rosenhan include?

Answer 35

A teaching and research hospital that was aware of the first study informed that during the next three months, one or more pseudo patients attempted to be admitted into each hospital

Each member of staff was asked to rate on a 10-point scale each new patient as to the likelihood of their being a pseudo patient (but to treat everyone as they wren a real patient so that no-one would miss out on the treatment they needed)

In practice, no pseudo patients attempted to be admitted f=during this period, so the staff were rating at their regular intake.

Number of patients judged: 193

Number of patients confidently judged as pseudopatients by at least one staff member: 41

Number of patients confidently judged as pseudopatients by at least one psychiatrist: 23

Number of patients confidently judged as pseudopatients by at least one staff member and psychiatrist: 19

Question 36

What are the conclusions of Rosenhan?

Answer 36

Mental hospitals in the USA in the early 1970s were not very good at making valid diagnoses

Mental hospitals in the USA in the early 1970s were not very good at making reliable diagnoses

Mental Hospitals in the USA in the early 1970s tended to view all behaviours as reflecting the diagnoses a patient had been given

Patients in mental hospitals in the USA in the early 1970s were often treated with profound disrespect

Question 37

What is the treatment for depression and schizophrenia?

Answer 37

It would be focused on restoring normal levels of neurotransmitter action:

Treating depression by blocking the reuptake of serotonin to ensure there is enough serotonin available for messages to get carried along the nervous system.

Treating schizophrenia by blocking receptors in post synaptic nerve cells to prevent an overload of dopamine reaching the post synaptic nerve cells.

Question 38

What is the genetic explanation of mental illness of genetics from parents?

Answer 38

The suggestion is that certain disorders could be passed from parents to children through genetic transmutation. Thus, children could inherit either a disorder or a disposition towards a disorder on much the same way that they might inherit eye colour or body shape.

Gottesman and Shields found that if one twin had schizophrenia then there was a 58% chance of an identical twin having it. However, if the twins were not identical, then there was only a 12% chance of a twin having it. This study suggests that there is a strong genetic component to schizophrenia, but it also suggests that occurrences of schizophrenia cannot be explained by genetics alone

Question 39

What is the genetic explanation of mental illness of evolutionary theory?

Answer 39

It has been proposed that there are certain traits in the past have enabled some people to survive while other people without these traits will have died. It is suggested that we have inherited traits that have a positive effect on our chances of survival.

Experimental support for this theory of ‘biological preparedness’ came from Ohman, who gave ppts electric shocks at the same time they saw pictures of either snakes,houses or human faces. It was easier to condition a fear response to the snakes than it as to either houses or human faces, suggesting an inherited biological predisposition to fear snakes more

Question 40

What is the treatment for genetic explanations?

Answer 40

Embryo manipulation to reduce the inheritance of physical disorders by using genetic material from three parents is in the early stages of research. In the future, will this approach also be taken to the. ‘treatment’ of mental disorders that are shown to have a strong genetic basis to them.

Question 41

What is the brain abnormality explanation of schizophrenia?

Answer 41

Brown et al revealed in post mortem studies comparing the brains of patients with schizophrenia against those with affective disorder - that the brain of schizophrenics were 6% lighter and had:
-Enlarged lateral ventricles
-Significantly thinner parpahippocampal cortices

Weinberger found by doing MRI scans of twins who were identical but who were not concordant for schizophrenia that there were differences between the two groups in the prefrontal cortex and the hippocampus volume.

Question 42

What would the treatment be for brain abnormality?

Answer 42

Drug therapy would be most likely, although in some cases surgery may be used (in the case of brain tumours that are producing symptoms of some disorders.

Question 43

What is the classical conditioning explanation of phobias?

Answer 43

The pairing of one unconditioned stimulus with another condition stimulus can lead to the unconditioned stimulus on its own being enough to produce the conditioned response of fear.

Little Albert acquired a phobia by the research of playing a loud noise with a white rat. originally little Albert had no fears.

Question 44

What is the operant conditioning explanation of phobias?

Answer 44

linking rewards we get when we show a phobia or other rewards. People with depression caused by traumatic events may receive attention to be rewarded for showing signs of a disorder. Negative reinforcement in anxiety disorders also occurs . For example , someone with a phobia of lifts walking away from the left and taking the stairs is like taking away anxiety by walking away.

Question 45

What is the social learning theory explanation of phobias?

Answer 45

behaviour such as depression can be seen in a child who has witnessed symptoms of depression such as withdrawal and mood swings.

Question 46

What is the cognitive explanation of mental illness?

Answer 46

Aaron Beck suggested that there are three main dysfunctional beliefs in people with depression which form cognitive triad.

I am worthless or flawed
everything I do will result in failure
The future is hopeless

He suggested that when a person becomes depressed, they would seek out information to confirm their negative beliefs like one or more negative things may happen on a good day and you focus on the bad rather than the good.

Ellis proposed that irrational thought could cause and sustain mental disorders, and believed that faulty cognitions can be summarised within the following three points:

-I must be outstandingly competent, otherwise I am worthless.

-Others must treat me considerately, or they are absolutely rotten.

-The world should always give me happiness, or I will die.

They are highly unrealistic expectations to have, and therefore they are not attained. The person is likely to fail like a failure and lead to depression.

Question 47

What is the psychodynamic explanation of mental illness?

Answer 47

-Unconcious memories and feelings will manifest themselves into our behaviour

-Conflicts between the ID, Ego and Superego can create anxiety or guilt depending on whether we satisfy the ID’s demands or not

-A weak and ineffective ego could result in the ID not being controlled. May lead to loss of contact with reality as person is unable to identify where their desires/fantasies end and reality begins (like schizophrenia

-Ego defence mechanisms can be involved, for example:

-Overiusing denial like refusing to acknowledge that a relationship is over can result in depression or anxiety

-Repression may cause a person to act unconsciously motivated by the repressed memory, e.g abuse when child may influence future relationships

Likely treatments are psychoanalysis which aims to bring unconscious emotions and conflicts into the conscious mind so that they can be resolved for example through dream analysis.

Question 48

What is aversion therapy?

Answer 48

This can be used to produce an unpleasant association like nausea in alcohol addiction. A drug called an emetic can be used to make people sick. Repeated painting will result in a learned response of aversion alcohol

Question 49

What is a non biological treatment of one specific disorder?

Answer 49

Rational Emotive Therapy (RET)

RET is looking for beliefs/thoughts which are irrational or unhelpful to us. Stress is caused by these irrational beliefs and thought processes.

Awfulizing- Its awful, didn’t get the job I applied for

Musterbating- People must like me or I’m worthless

Catastrophising- if I don’t succeed I will die

The client is helped to understand how these beliefes are contributing to their illness, and helped to identify an alternative way of processing a situation which in turn should change their behaviour.

A- Identifying the activating event
B- Beliefs
C- Consequences
D- Disputing
E- Effects