P3: (A) issues in mental health Flashcards

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1
Q

what is the history of the madhouse BBC documentary?

A

Asylums, vast Victorian, 31 beds in one dorm
-patients dumped there
-Ect induced seizure to ease depression
-insulin therapy induced coma
-lobotomy
-used to pay to see patients and make fun of them

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2
Q

what are some historical facts of the view of mental health?

A

-prehistoric believed madness caused by possession of devil
-talking therapy introduced in late 1700s
-women more likely to be accused of demonic possession
- burn mental health victims at the stake

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3
Q

what is an early example of historic treatment?

A

65000BC and Middle Ages
Trepanning
used for all mental illness
-cause of illness devils, spirits and demons
-2 holes in skull to release demons

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4
Q

what is a middle example from the timeline of historic treatment

A

17th and 18th century
moral treatments by Tuke
-cause of mental illness any emotional stressors
-talking, nurturing, comforting
removes stressors

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5
Q

what is a recent example of historical treatment?

A

-1950’s
-medical model (drugs)
-used for depression, schizophrenia and many illness
-cause of mental illness biological disturbance
-alters chemical imbalance in patients body

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6
Q

What are Rosenhan and Seligman 4 definitions of abnormality?

A
  • statistical infrequency
    -deviation form social norms
    -failure to function adequately
    -deviation from ideal mental health
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7
Q

what is statistical infrequency?

A

a behaviour that is statistically not seen in society often
-report of the national Audit of schizophrenia found it was present in 3.45% of Uk

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8
Q

what are strengths of statistical infrequency?

A

-enables abnormality to be quantified which is objective
-allows statistical analysis of a difficult behaviour

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9
Q

what are weaknesses of statistical infrequency?

A

-difficult to quantify all abnormal behaviour
-reduced generalisability average may not be the norm in all cultures

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10
Q

what is deviation from social norms?

A

a person who doesn’t behave in a way society expects
-being unemployed, taking drugs
depends on norms of different cultures

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11
Q

what are strengths of deviation from social norms?

A

-considers the cultures and can be varied for each society taking into account individual differences
-allows for changes to occur in society could be considered as a holistic approach

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12
Q

what are weaknesses of deviation from social norms?

A

-difficult to decide wat can be classed as a normal behaviour
-can be considered more sociological than psychological

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13
Q

what is failure to function adequately?

A

-if a person is unable to live a normal life adequately
-gambling addiction
-ways a person may fail to function:
dysfunctional behaviour
distresses the person
makes observer uncomfortable
unpredictable behaviour
irrational behaviour

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14
Q

what are strengths of failure to function adequately?

A

considers feelings, if need help will be deemed abnormal and get it
-measurable scale
-behaviours observable so problems can be picked up and helped

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15
Q

what are weaknesses of failure to function adequately?

A

-difficult to determine what normal life is can vary in cultures
-maladaptive behaviour difficult to measure
ambiguous so questions validity and reliability

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16
Q

what is deviation from ideal mental health?

A

Jahoda
-positive attitudes towards self
-growth, development and self actualisation
-voluntary control over behaviour
-true perception of reality
-love, work and play
resistance to stress and frustration

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17
Q

what are strengths of deviation from ideal mental health?

A

-positive view looking at health
-allows professionals to see what a person is doing and not their inabilities

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18
Q

what are weaknesses from deviation from an ideal mental heath?

A

-open to interpretation, what contributes to healthy is difficult to quantify
-various elements can be displayed
-difficult to define in real terms

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19
Q

what is the ICD?

A

international classification of diseases
for all general diseases and illnesses
published by WHO
outside of USA
11th revision 2021
V is mental and behavioural disorders

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20
Q

what are some of the 10 main categories in the ICD?

A

-mood disorders
-disorders of psychological development
-unspecified mental disorders

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21
Q

what are strengths of the ICD?

A

more generalisable

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22
Q

what are weaknesses of the ICD?

A

vague, reliability reduced

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23
Q

what is the DSM?

A

-diagnostic and statistical manual of mental disorders
-last revision 2013
-published by APA
-diagnostic criteria in chapter 2

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24
Q

what are some of the categories in the DSM?

A

bipolar and related disorders
depressive disorders
feeding and eating disorders
personality disorders

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25
Q

what are strengths of the DSM?

A

-multi axel tool, looks at how frequently someone is displaying the disorders which reinforces the accuracy

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26
Q

what are the weaknesses of the DSM?

A

-deterministic, only focusses on mental health and not biological

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27
Q

what are similarities between the ICD and DSM?

A

-holistic (to an extent) multiple categories and varieties of mental illnesses

-deterministic- may not fit into chapters and categories, comorbidity (difficult to accurately diagnose)

-both have practical applications

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28
Q

what are differences between the ICD and DSM?

A

-ICD more generalisable than DSM
-ICD more scientific considers biological issues
-ICD more valid as updated in 2021 not 2013

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29
Q

what is the aim for rosenhan 1?

A

investigate if a group of sane people could be falsely diagnosed and admitted to psychiatric hospitals by presenting themselves as having a psychiatric disorder

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30
Q

what is the sample for rosenhan 1?

A

8 confederates 5m 3f
-hospital staff 12 psychiatric hospitals 5dif states

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31
Q

what was the research method for rosenhan 1?

A

participant naturalistic observation

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32
Q

what was the procedure for rosenhan 1?

A

-p call hospital for appointment
-heard voices say empty hollow thud
voices unclear and unfamiliar, same sex
gave false names, occupations but real life histories
-took part in ward activities, speaking ordinarily
-have to get out on own devices
-wrote observations

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33
Q

what were results for rosenhan 1?

A

all patients diagnosed with schizophrenia one with manic depression
-interpreted behaviour in context of diagnoses
-average stay 19 days
- 35 real patients detected sanity
-experienced depersonalisation and powerlessness

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34
Q

what was some of the abuse experienced by patients in rosenhan 1?

A

medical records open
no toilet doors
staff brutal

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35
Q

what was the aim for rosenhan 2?

A

investigate if study 1 would be impacted by the knowledge of mistaken diagnoses

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36
Q

what was the sample for rosenhan 2?

A

staff in one of the 12 hospitals told the results from study 1 which they found it hard to believe

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37
Q

what was the research method for rosenhan 2?

A

questionnaire

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38
Q

what was the procedure for rosenhan 2?

A

-staff told hospital would admit one pseudo patient in next three months

-each staff rated liklehood they were a pseudo patient there were non

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39
Q

what were the results for rosenhan 2?

A

-staff regarded real patients as sane
-incorrectly rated 83/193 patients
-10% or regular intake judged by psychiatrist to be pseudo

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40
Q

what is a type 2 error in rosenhan research?

A

someone who is insane being diagnosed as sane

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41
Q

what’s is a type 1 error in rosenhan

A

someone who is sane being diagnosed as insane

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42
Q

what are conclusions for rosenhan?

A

-psychiatrists can’t reliably tell the difference between sane and insane people
-physicians may not identify sanity as it is less risky to diagnose a healthy person as sick
-stickiness of labels- contextualised in light

43
Q

what are strengths of rosenhan study?

A

-ecologically valid
-identifies situational reasons for errors in diagnosis

44
Q

what are the weaknesses of rosenhan study?

A

-ethical issues
-ethnocentric

45
Q

what does the biochemical explanation focus on?

A

focused on abnormal levels of neurotransmitters

46
Q

what is the dopamine hypothesis?

A

-sz occurs due to excess dopamine
-new= excess of D2 receptors
-positive symptoms= extra
linked with hypofunction in the mesolimbic pathway
-negative symptoms= missing behaviours
linked to dopamine functions in mesocortical pathway

47
Q

how did Seeman support dopamine hypothesis?

A

-drugs increase dopamine cause hallucinations
-antipsychotic drugs block dopamine receptors and reduce symptoms
-postmortems of sz brain show higher density of D2 receptors

48
Q

what does the brain abnormality explanation focus on?

A

mental health patients brains differ from neurotypical people’s
individuals brain differs when ill compared to healthy

49
Q

what is the prefrontal cortex?

A

cognitive control
less self control and impaired

50
Q

what is the limbic system?

A

emotion behaviour motivation

51
Q

what is the amygdala?

A

sensory regulation emotions (fears)

52
Q

what is the amygdala in relation to brain abnormality?

A

activity increases in depressed
-Sheline: FMRI 11 healthy and unhealthy more active in i’ll
-antidepressant medication reduced activity

53
Q

what is the hippocampus in relation to brain abnormality?

A

significantly smaller volume for people suffering with depression (20%)
-Kronmuller= MRI identities significantly smaller hippocampus in depressed

54
Q

what does the genetic explanation focus on?

A

the more genes people share the more similar their behaviour will be
measured correlation between proband and their relatives

55
Q

what was the family studies in the genetic explanation?

A

-comparing proband to a range of family members who share DNA at different levels
-siblings/parents 50/100%
general risk 1%
Gottesman- risk 7% with one parent

56
Q

What was the twin studies in relation to genetic explanation?

A

-monozygotic= 100% dna
-Dizygotic= 50% dna
both twins should have condition
-46-53% if twin has sz (mz)
-15% (dz)

57
Q

what was the adoptive studies in the genetic explanation?

A

-comparing proband to adoptive parents and biological parents
-should be no correlation
-Finnish study- Tienari
lifetime risk if mother Sz 9.4%
lifetime risk if doesn’t 1.2%

58
Q

what was Gottesmans aim?

A

investigate using larger samples the likelihood of offspring being diagnosed with sz, bipolar if one or both parents have been previously diagnosed

59
Q

what is the method for Gottesman?

A

secondary data regarding the Danish population to find a correlation between parental and offspring diagnosis

60
Q

what was the sample for Gottesman?

A

3,391,018 Danish

61
Q

what registers were used for the sample?

A

-The Danish Civil Registration- born between 1968-96
-The Danish Psychiatric Central Register- all admission between 1970-2007

62
Q

what was the procedure for Gottesman?

A

data linked with parents psychiatric history
civil registration checked who parents were and if they were on the psychiatric register
researchers then identified any person with sz, bipolar, major depression

63
Q

what were the results and findings for Gottesman?

A

-risk of sz + bipolar by 52 27.3% if both parents diagnosed
-risk sz by 52 7% with one diagnosed parent
-similar risk with bipolar

64
Q

what was Gottesman results and findings?

A

-super high risk of psychosis if both parents have it
-strong role of genetics
-relationship not 100% meaning environment may impact
-useful for genetic counsellors to inform personal decisions like marriage adoption and family formation

65
Q

what are strengths of Gottesman?

A

-quantitative data
-practical applications
-individual explanation
-socially sensitive

66
Q

what are weaknesses of Gottesman?

A

-ethnocentric
-low validity secondary data
-nature
-reductionist

67
Q

what is ect?

A

electro convulsive therapy
for depression

68
Q

how does ect work?

A

-induced convulsion
-last 20-50s
-electric current changed activity of neurotransmitters (dopamine)
-stimulated limbic system

69
Q

what are types of ect?

A

unilateral
bilateral

70
Q

how is ect administered?

A

anaesthetic
6/8 treatments over three weeks
closely monitored

71
Q

what are strengths of ect?

A

-effective 86% ect treatments for depression
-not effective at reducing symptoms of depression than pharmacotherapy (bilateral more effective)

72
Q

what are weaknesses of ect?

A

-generalisability (not everyone has depression because of a biological cause)
-high relapse rate (51.1%) within six months
-side effects= headaches, aching muscles, feeling dizzy

73
Q

what is Mowrers two process theory?

A

identified the initiation of phobias and their maintenance
1) initiation (classical) neutral stimuli becomes associated with an unpleasant experience
2) maintenance (operant) negative reinforcement, staying away from feared object
(little albert)

74
Q

how does operant conditioning relate to depression?

A

-positive reinforcement from the environment removed
(person passes away no longer get positive reinforcement of spending time with them)
-avoidance don’t seek other social situation
-friends give attention (positive reinforcement)

75
Q

what is Mowrers two process theory in relation to phobias?

A
  • initiation (classical) neutral stimulus associated with unpleasant experience

-maintenance (operant) phobias maintained by negative reinforcement

76
Q

what’s Becks cognitive triad?

A

pessimistic view about
-self
-future
-world

77
Q

what is overgeneralisation in cognitive distortion?

A

view one unfortunate event as part of a never ending defeat

78
Q

what is filtering in cognitive distortion?

A

greater focus to negative aspects whilst ignoring or downplaying a positive one

79
Q

what is catastrophising in cognitive distortion?

A

mountain out of a molehill

80
Q

what is dichotomous thinking in cognitive distortion?

A

All or nothing thinking

81
Q

what are key assumptions of the humanist approach?

A

-individuals have free will to determine their own mental health through positive thinking and self actualisation

-rejects reductionist ideas that mental health problems are down to biology

82
Q

what is Maslow hierarchy?

A

factors that stimulate us to behave how we do in our day to day lives
needs in hierarchy just be met to function adequately

83
Q

how does Maslow hierarchy related to mental health?

A

jahoda
need to fulfil hierarchy to achieve self actualisation and maintain a positive mental health

84
Q

what is carl rogers flower analogy?

A

‘in the right conditions a flower will grow to its full potential’
in order to achieve self actualisation may need a supportive environment

85
Q

how does carl rogers flower analogy link to mental illness?

A

if we have a supportive environment we can reach self actualisation and view ourselves positively (self conceptualisation)

86
Q

how does carl rogers flower analogy link to mental illness?

A

if we have a supportive environment we can reach self actualisation and view ourselves positively (self conceptualisation)

87
Q

what is Szasz’s study?

A

-collection of arguments from writings
-article
-‘The Myth of Mental Illness:50 years later’

88
Q

what were Szasz aims?

A

-challenge the medical concept of mental illness

-reject image of helpless patients who are under control of biological issues

-stop coercive practices that isolate and restrict the lives who don’t fit societies norms and values

89
Q

What did Szasz say about mental illness being a metaphor?

A

-sz being used to explain symptoms that are likely due to other medical bodily illnesses that have been missed

-if we could accurately identify the somatic diseases that cause the atypical behaviour then we could get rid of all mental disorders from the past 200 years

90
Q

what does Szasz say about mental illness as a medical or legal concept?

A

-regular changes in what constitutes as mental illness (homosexuality) shows mental illness is a social construct

-mental illness is a term given to citizens for state to create a new class, mental hospitals are like prison

91
Q

what does Szasz say about the label of sz?

A

-justifies negative conceptualisation of oneself
-enables suicide instead of self actualisation

92
Q

what theory is systematic desensitisation?

A

behaviourist
classical conditioning

93
Q

what is counter conditioning in systematic desensitisation?

A

-patient taught new association through classical conditioning
-phobic stimuli and new response of relaxation instead of fear

94
Q

what are the four main strategies of systematic desensitisation?

A

-functional analysis
-construction of an anxiety hierarchy
-relaxation training
-gradual exposure

95
Q

what is functional analysis?

A

-discussion between therapist and patient
-discover reasons for phobia and their reactions

96
Q

what is the construction of an anxiety hierarchy?

A

-rate phobic situations least to most fearful

97
Q

what is relaxation training?

A

-therapist teaches relaxation techniques
-self hypnosis, breathing exercise, progressive muscle relaxation

98
Q

what is gradual exposure?

A

-introduced to fear situation through hierarchy
-move up hierarchy based on fear response
-repeated over several sessions

99
Q

what is a strength of the behaviourist explanation?

A

Freewill
SLT suggests phobias learnt by imitating role models who display fear responses
-people can change these role models to more positive ones
-optimistic

100
Q

what is a strength of Humanism?

A

-nurture as it focusses on environmental factors
-Maslows hierarchy identifies needs from environment to reach self actualisation
-optimistic as we can change our environment

101
Q

what is a strength of Szasz’s research?

A

-socially sensitive so challenges historic notions
-MH is a social construct (homosexuality)
-harmful medication not needed and instead talking therapy etc

102
Q

what is a weakness of Szasz’s research?

A

-not scientific
-qualitative data
-lacks objective evidence to ensure validity
(purposefully avoids scientific arguments as this led to politicisation of mental illness)

103
Q

strengths of systematic desensitisation?

A

-useful- doesn’t require expensive professionals
-free will- change behaviour through controlling stimuli in our environment and re learning responses through ethical/ positive outlook

104
Q

weakness of systematic desensitisation?

A

-unethical- expose individual to phobia and induced anxiety response

-practical/ useful- may no work for all phobias such a flying