Mental Health - The Medical Model

Question 1

Biochemical explanations (Background)

Answer 1

• Based on neurotransmitters or hormones being attributed to impacting behaviour
• Can collect empirical evidence through postmortems, collecting spinal fluid and giving medication to see any adjustment in behaviour

Question 2

Biochemical - Monoamine theory of Depression (Background)

Answer 2

• Predicts that the underlying basis of depression is a depletion in levels of serotonin, noradrenaline and/or dopamine in the CNS
• Electrical impulses go across synapses in our nerve cells, but a lack of these monoamines mean that there is disregulation in the amounts of the hormone your brain is getting
  
  • Serotonin cannot regulate other neurotransmitters the way it is supposed to
  • Dopamine attributes to low mood
  • Noradrenaline affects sleep and causes fatigue

Question 3

Genetic explanations (Background)

Answer 3

Attribute disorders to genetic factors i.e. things found in one’s DNA and the idea that some disorders are hereditary

Question 4

Genetic - Family Inheritance theory of Schizophrenia (Background)

Answer 4

• The closer you are related to a person in your family, the more likely you will have schizophrenia e.g. 50% for identical twins vs 5% for grandchildren
• If you share more genes with someone, the higher likelihood you will have schizophrenia

Question 5

Brain Abnormality explanations (Background)

Answer 5

Attributes mental disorders to abnormalities in different areas of the brain

Question 6

Brain Abnormality - Frontal Lobe theory of Depression (Background)

Answer 6

• Studies such as Coffey et al. have shown the volume of the frontal lobe is significantly smaller in those who have depression
• Studies such as Milo et al. have also shown that this has led to hyperfusion in the brain (less blood flow)

Question 7

SSRI Drugs (Application)

Answer 7

• SSRIs work by blocking the serotonin from going into the postsynaptic cell and being reused
• This means the amount of serotonin in the synapse will increase, increasing the mood of the depressed individual
• Patients will start on lowest doses necessary to improve depression symptoms
• Have to be taken for 1-2 weeks before feeling any effects

Question 8

Strengths of SSRIs

Answer 8

• Can reduce suicide rates or harmful effects of depression
• SSRIs work quickly and improve mood significantly
• Easy to be prescribed and take
• Cheaper for NHS than ECT or counselling

Question 9

Weaknesses of SSRIs

Answer 9

• Dependency
• Side effects include nausea, insomnia, headaches
• A more short term solution which isn’t effective for everyone
• Revolving door - you feel better so stop taking them, but then it get worse again so have to start taking them again

Question 10

Gottesman - Aim

Answer 10

To calculate the risk to offspring of having both parents with a psychiatric disorder

Question 11

Gottesman - Method

Answer 11

• National register-based cohort study/natural experiment done in Denmark
• IV - parent diagnosed w schizophrenia, bipolar or neither
• DV - children diagnosed with any mental illness according to the ICD-10
• Used secondary data and conducted data analysis on these records

Question 12

Gottesman - Sample

Answer 12

• 2.6 million people born before 1997 who had an identifiable parent with scz or bipolar
• 196 couples both w scz, 83 couples both with bipolar (270 and 146 children respectively)
• 8006 couples one parent w scz, 11995 couples one parent w bipolar (14000 and 23000 children respectively)

Question 13

Gottesman - Results

Answer 13

• 2 parents w scz - 27.3% children get scz
• 2 parents w bipolar - 24.9% children get bipolar
• Scz + any mental illness - 67.5% children w mental illness
• One parent w scz - 7% children get scz
• One parent w bipolar - 4.4% children get bipolar
• Neither parent w mental disorder - 1.1% chance for scz and 0.6% chance for bipolar in their children

Question 14

Gottesman - Conclusions

Answer 14

• The offspring of dual matings diagnosed w psychosis constitute a super-high-risk sample of psychosis
• The role fo genetics in scz and other mental health issues are highly influential
• There is evidence to support the genetic explanation of mental illness
• Genetic counselling should be offered to those w psychosis to inform personal decisions with regard to marriage, family formation, adoption and health insurance planning

Question 15

Gottesman - Reliability

Answer 15

• Internal reliability due to data all being analysed in the same computer database
• However, may not be reliability across psychiatrists (because people get diagnosed from GPs, psychiatrists, doctors); lower inter-rater reliability
• Test-retest - study could be carried out in other countries to see if scz/bipolar stats still hold true in other cultures