P3: (A) issues in mental health Flashcards
what is the history of the madhouse BBC documentary?
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
what are some historical facts of the view of mental health?
-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
what is an early example of historic treatment?
65000BC and Middle Ages
Trepanning
used for all mental illness
-cause of illness devils, spirits and demons
-2 holes in skull to release demons
what is a middle example from the timeline of historic treatment
17th and 18th century
moral treatments by Tuke
-cause of mental illness any emotional stressors
-talking, nurturing, comforting
removes stressors
what is a recent example of historical treatment?
-1950’s
-medical model (drugs)
-used for depression, schizophrenia and many illness
-cause of mental illness biological disturbance
-alters chemical imbalance in patients body
What are Rosenhan and Seligman 4 definitions of abnormality?
- statistical infrequency
-deviation form social norms
-failure to function adequately
-deviation from ideal mental health
what is statistical infrequency?
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
what are strengths of statistical infrequency?
-enables abnormality to be quantified which is objective
-allows statistical analysis of a difficult behaviour
what are weaknesses of statistical infrequency?
-difficult to quantify all abnormal behaviour
-reduced generalisability average may not be the norm in all cultures
what is deviation from social norms?
a person who doesn’t behave in a way society expects
-being unemployed, taking drugs
depends on norms of different cultures
what are strengths of deviation from social norms?
-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
what are weaknesses of deviation from social norms?
-difficult to decide wat can be classed as a normal behaviour
-can be considered more sociological than psychological
what is failure to function adequately?
-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
what are strengths of failure to function adequately?
considers feelings, if need help will be deemed abnormal and get it
-measurable scale
-behaviours observable so problems can be picked up and helped
what are weaknesses of failure to function adequately?
-difficult to determine what normal life is can vary in cultures
-maladaptive behaviour difficult to measure
ambiguous so questions validity and reliability
what is deviation from ideal mental health?
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
what are strengths of deviation from ideal mental health?
-positive view looking at health
-allows professionals to see what a person is doing and not their inabilities
what are weaknesses from deviation from an ideal mental heath?
-open to interpretation, what contributes to healthy is difficult to quantify
-various elements can be displayed
-difficult to define in real terms
what is the ICD?
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
what are some of the 10 main categories in the ICD?
-mood disorders
-disorders of psychological development
-unspecified mental disorders
what are strengths of the ICD?
more generalisable
what are weaknesses of the ICD?
vague, reliability reduced
what is the DSM?
-diagnostic and statistical manual of mental disorders
-last revision 2013
-published by APA
-diagnostic criteria in chapter 2
what are some of the categories in the DSM?
bipolar and related disorders
depressive disorders
feeding and eating disorders
personality disorders
what are strengths of the DSM?
-multi axel tool, looks at how frequently someone is displaying the disorders which reinforces the accuracy
what are the weaknesses of the DSM?
-deterministic, only focusses on mental health and not biological
what are similarities between the ICD and DSM?
-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
what are differences between the ICD and DSM?
-ICD more generalisable than DSM
-ICD more scientific considers biological issues
-ICD more valid as updated in 2021 not 2013
what is the aim for rosenhan 1?
investigate if a group of sane people could be falsely diagnosed and admitted to psychiatric hospitals by presenting themselves as having a psychiatric disorder
what is the sample for rosenhan 1?
8 confederates 5m 3f
-hospital staff 12 psychiatric hospitals 5dif states
what was the research method for rosenhan 1?
participant naturalistic observation
what was the procedure for rosenhan 1?
-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
what were results for rosenhan 1?
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
what was some of the abuse experienced by patients in rosenhan 1?
medical records open
no toilet doors
staff brutal
what was the aim for rosenhan 2?
investigate if study 1 would be impacted by the knowledge of mistaken diagnoses
what was the sample for rosenhan 2?
staff in one of the 12 hospitals told the results from study 1 which they found it hard to believe
what was the research method for rosenhan 2?
questionnaire
what was the procedure for rosenhan 2?
-staff told hospital would admit one pseudo patient in next three months
-each staff rated liklehood they were a pseudo patient there were non
what were the results for rosenhan 2?
-staff regarded real patients as sane
-incorrectly rated 83/193 patients
-10% or regular intake judged by psychiatrist to be pseudo
what is a type 2 error in rosenhan research?
someone who is insane being diagnosed as sane
what’s is a type 1 error in rosenhan
someone who is sane being diagnosed as insane
what are conclusions for rosenhan?
-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
what are strengths of rosenhan study?
-ecologically valid
-identifies situational reasons for errors in diagnosis
what are the weaknesses of rosenhan study?
-ethical issues
-ethnocentric
what does the biochemical explanation focus on?
focused on abnormal levels of neurotransmitters
what is the dopamine hypothesis?
-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
how did Seeman support dopamine hypothesis?
-drugs increase dopamine cause hallucinations
-antipsychotic drugs block dopamine receptors and reduce symptoms
-postmortems of sz brain show higher density of D2 receptors
what does the brain abnormality explanation focus on?
mental health patients brains differ from neurotypical people’s
individuals brain differs when ill compared to healthy
what is the prefrontal cortex?
cognitive control
less self control and impaired
what is the limbic system?
emotion behaviour motivation
what is the amygdala?
sensory regulation emotions (fears)
what is the amygdala in relation to brain abnormality?
activity increases in depressed
-Sheline: FMRI 11 healthy and unhealthy more active in i’ll
-antidepressant medication reduced activity
what is the hippocampus in relation to brain abnormality?
significantly smaller volume for people suffering with depression (20%)
-Kronmuller= MRI identities significantly smaller hippocampus in depressed
what does the genetic explanation focus on?
the more genes people share the more similar their behaviour will be
measured correlation between proband and their relatives
what was the family studies in the genetic explanation?
-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
What was the twin studies in relation to genetic explanation?
-monozygotic= 100% dna
-Dizygotic= 50% dna
both twins should have condition
-46-53% if twin has sz (mz)
-15% (dz)
what was the adoptive studies in the genetic explanation?
-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%
what was Gottesmans aim?
investigate using larger samples the likelihood of offspring being diagnosed with sz, bipolar if one or both parents have been previously diagnosed
what is the method for Gottesman?
secondary data regarding the Danish population to find a correlation between parental and offspring diagnosis
what was the sample for Gottesman?
3,391,018 Danish
what registers were used for the sample?
-The Danish Civil Registration- born between 1968-96
-The Danish Psychiatric Central Register- all admission between 1970-2007
what was the procedure for Gottesman?
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
what were the results and findings for Gottesman?
-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
what was Gottesman results and findings?
-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
what are strengths of Gottesman?
-quantitative data
-practical applications
-individual explanation
-socially sensitive
what are weaknesses of Gottesman?
-ethnocentric
-low validity secondary data
-nature
-reductionist
what is ect?
electro convulsive therapy
for depression
how does ect work?
-induced convulsion
-last 20-50s
-electric current changed activity of neurotransmitters (dopamine)
-stimulated limbic system
what are types of ect?
unilateral
bilateral
how is ect administered?
anaesthetic
6/8 treatments over three weeks
closely monitored
what are strengths of ect?
-effective 86% ect treatments for depression
-not effective at reducing symptoms of depression than pharmacotherapy (bilateral more effective)
what are weaknesses of ect?
-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
what is Mowrers two process theory?
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)
how does operant conditioning relate to depression?
-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)
what is Mowrers two process theory in relation to phobias?
- initiation (classical) neutral stimulus associated with unpleasant experience
-maintenance (operant) phobias maintained by negative reinforcement
what’s Becks cognitive triad?
pessimistic view about
-self
-future
-world
what is overgeneralisation in cognitive distortion?
view one unfortunate event as part of a never ending defeat
what is filtering in cognitive distortion?
greater focus to negative aspects whilst ignoring or downplaying a positive one
what is catastrophising in cognitive distortion?
mountain out of a molehill
what is dichotomous thinking in cognitive distortion?
All or nothing thinking
what are key assumptions of the humanist approach?
-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
what is Maslow hierarchy?
factors that stimulate us to behave how we do in our day to day lives
needs in hierarchy just be met to function adequately
how does Maslow hierarchy related to mental health?
jahoda
need to fulfil hierarchy to achieve self actualisation and maintain a positive mental health
what is carl rogers flower analogy?
‘in the right conditions a flower will grow to its full potential’
in order to achieve self actualisation may need a supportive environment
how does carl rogers flower analogy link to mental illness?
if we have a supportive environment we can reach self actualisation and view ourselves positively (self conceptualisation)
how does carl rogers flower analogy link to mental illness?
if we have a supportive environment we can reach self actualisation and view ourselves positively (self conceptualisation)
what is Szasz’s study?
-collection of arguments from writings
-article
-‘The Myth of Mental Illness:50 years later’
what were Szasz aims?
-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
What did Szasz say about mental illness being a metaphor?
-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
what does Szasz say about mental illness as a medical or legal concept?
-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
what does Szasz say about the label of sz?
-justifies negative conceptualisation of oneself
-enables suicide instead of self actualisation
what theory is systematic desensitisation?
behaviourist
classical conditioning
what is counter conditioning in systematic desensitisation?
-patient taught new association through classical conditioning
-phobic stimuli and new response of relaxation instead of fear
what are the four main strategies of systematic desensitisation?
-functional analysis
-construction of an anxiety hierarchy
-relaxation training
-gradual exposure
what is functional analysis?
-discussion between therapist and patient
-discover reasons for phobia and their reactions
what is the construction of an anxiety hierarchy?
-rate phobic situations least to most fearful
what is relaxation training?
-therapist teaches relaxation techniques
-self hypnosis, breathing exercise, progressive muscle relaxation
what is gradual exposure?
-introduced to fear situation through hierarchy
-move up hierarchy based on fear response
-repeated over several sessions
what is a strength of the behaviourist explanation?
Freewill
SLT suggests phobias learnt by imitating role models who display fear responses
-people can change these role models to more positive ones
-optimistic
what is a strength of Humanism?
-nurture as it focusses on environmental factors
-Maslows hierarchy identifies needs from environment to reach self actualisation
-optimistic as we can change our environment
what is a strength of Szasz’s research?
-socially sensitive so challenges historic notions
-MH is a social construct (homosexuality)
-harmful medication not needed and instead talking therapy etc
what is a weakness of Szasz’s research?
-not scientific
-qualitative data
-lacks objective evidence to ensure validity
(purposefully avoids scientific arguments as this led to politicisation of mental illness)
strengths of systematic desensitisation?
-useful- doesn’t require expensive professionals
-free will- change behaviour through controlling stimuli in our environment and re learning responses through ethical/ positive outlook
weakness of systematic desensitisation?
-unethical- expose individual to phobia and induced anxiety response
-practical/ useful- may no work for all phobias such a flying
