Paper 3 - Mental Health Flashcards
Explain how the key research by Rosenhan (1973) contributes to an understanding of individual, social and cultural diversity.
How do you structure this question.
Sentence starter:
It contributes to understanding of cultural /individual/ social diversity because …
Separate into 3 sections but write as one paragraph:
. Individual diversity
. Social diversity
. Cultural diversity
5-6 marks - Response demonstrates good application of psychological knowledge and understanding. There is good relevant knowledge and understanding.
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Model answer:
In relation to individual diversity, candidates could point to the way in which 35 patients (but no staff members) suspected the pseudopatiants of faking their symptoms in study 1; from study 2, they could point to differences between members of staff in their ratings.of whether the 193 patients were pseudopatients or not. Social diversity could be illustrated by the way in which one social group (students) were treated differently from another social group (patients diagnosed with mental disorders) when they asked an innocuous question. The study could be said to contribute to an understanding of cultural diversity by illustrating how, in one particular culture (the USA), mental disorders are/were (mis)diagnosed; points could also be made about how patients in mental hospitals within this culture are/were treated.
Outline one similarity/difference between two historical views of mental illness.
(3 marks)
1) how do you structure this question
2) what points can you include
1) Structure
1 mark - state the similarity between historical views of mental illness
1 mark - support with relevant evidence from 1 historical view
1 mark - support with relevant evidence from the other historical view
The similarity should be clearly identified, and linked to two historical views of mental
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2)
AO1 ( 2 marks )
Examples of relevant historical views:
anything in the 1960’s or earlier can be treated as historical
—
. demonic possession (treated through trepanning)
. witchcraft
. an imbalance in the four humours (including reference to elements, seasons and/or temperature)
. moral treatment
. psychodynamic perspective,
. the anti-psychiatry movement,
. abnormal levels of neurotransmitters.
——
AO3 (1 mark)
The similarity/difference could be based around/ include:
Debates:
E.g.
>psychology as a science; >reductionism/holism
>freewill/determinism;
. Areas
E.g. biological
. Issues
E.g. ethics
. Beliefs and treatments of each view
. Eg. They have having similar causes; leading to similar treatments.
Describe the characteristics of an anxiety disorder.
3 marks
How would you structure this.
For three marks:
1 mark - name the anxiety disorder
2 marks - outline 2 characteristics of the disorder.
(alternatively, outlining three characteristics with it being clear what the candidate is referring to would also get 3 marks even if a specific anxiety disorder has not been named.)
————
What could include for the characteristics:
When describing characteristics, candidates can refer to symptoms but need to convey the extreme nature of them to bring out the ‘disorder’ part of what they are describing as well as the ‘anxiety’ part of it
(e.g. avoidance, irrationality, fear or nervousness beyond that which a person might normally feel, signs of physiological arousal that are extreme and/or linked to anxiety rather than some other cause).
Discuss the usefulness of knowing the characteristics of disorders.
(5 marks)
Structure:
There is good evaluation that is mainly relevant to the demand of the question.
> two points about usefulness that are distinct from each other and elaborated, with at least one being linked explicitly to characteristics of disorders.
————
Points could make:
Useful
. Could lead to more accurate diagnosis or the administration of appropriate treatment.
. Candidates might also refer to how individuals could feel reassured by an awareness that their experiences arise from a recognised disorder, or how it could help the individual to cope better with the demands placed on them through work, caring responsibilities, etc.
Not useful
. usefulness of such knowledge is reduced if it adds to a person’s anxiety levels, leads to inaccurate lay ‘diagnoses’, or leads to people noticing ‘symptoms’ that they might not otherwise notice.
-
. Points discussed need to be linked to usefulness (i.e. to practical applications).
—————-
Examiners report:
Successful responses could identify why knowing characteristics was positive (diagnosis and treatment) and balanced this with a consideration of individual differences or reliability of using DSM/ICD. Candidates who simply described characteristics of disorders or treatments in detail gain few, if any, marks.
To what extent can historical views be considered scientific.
7 marks
How would you structure it?
Structure:
Sentence starters:
To some extent the historical view can be scientific because …
Give examples
However, it could be argued that the historical views isn’t scientific because…
Give a conclusion
. requirements of the question: need for plurality (i.e. more than one) of the historical views.
————
Examiners report:
. The more usual features being cited were unfalsifiable and subjective. These could apply to many of the historical views.
. Candidates often tried to balance their argument with views that were more scientific and links to the sciences of biology and chemistry were given marks as making a view more scientific.
. The extent to which the views are scientific was often lost in description.
————
Points could make in answers:
Scientific
. The theory of the four humours could be defended as at least being based in physiology.
Not scientific
. Effects not being replicated;
. A lack of supporting empirical evidence from controlled experiments;
. No quantitative data;
. Explanations being supernatural;
. interpretations being subjective;
. it not being possible to prove theories false;
To be able to access the top level , candidates must express a judgement about the extent to which historical views of mental illness can be considered scientific. (conclusion)
Ali is behaving in a way that people regard as strange. Whatever events happen in Ali’s life, they do not seem to affect Ali’s mood at all. Ali remains constantly happy and excited.
(a) How might one of the historical views of mental illness explain Ali’s behaviour?
4 marks
How would you structure this.
A01 (2 marks)
Candidates will demonstrate knowledge and understanding through accurate reference to one of the historical views of mental illness (e.g. the four humours; demonic possession; etc.).
AO2 (2 marks)
Candidates are required to apply the historical view of mental illness to explain Ali’s behaviour.
For example, reference could be made to imbalance in the four humours, to Ali being possessed by evil spirits, etc.
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Example structure:
Identifying and elaborating a historical view:
1 mark - humour and example of humour
1 mark - explain the issue eg. Imbalance
1 mark - identify the characteristics of the issue eg. Excitability
1 mark - Link to Ali in the scenario
The key research by Rosenhan (1973) reports that mental hospital staff “delivered verbal and occasionally serious physical abuse to patients” in front of other patients. However, when other members of staff were known to be coming, this abuse was quickly stopped
(a) How did Rosenhan explain the behaviour of the abusive staff?
3 marks
What could you include
A02 (3 marks)
. The abuse itself could be explained in terms of staff being in a position of power and not seeing the patients as equals.
. However, to address the question of why the abuse was ended when another member of staff appeared, reference could be made to how other members of staff will have been seen as credible witnesses, while (owing to their diagnosis of a mental illness patients would not have been.
Candidates could identify any three from the characteristics of the practitioners which would make them likely to abuse. Eg:
. power
. characteristics of the patients likely to make them victims eg label;
. consequences eg verbal abuse.
This would also be the case for behaviour stopping, if the characteristics of the co-workers are identified eg likely to be believed.
Key research by Rosenhan (1973) reports that mental hospital staff “delivered verbal and occasionally serious physical abuse to patients” in front of other patients. However, when other members of staff were known to be coming, this abuse was quickly stopped
(b) Describe two ways in which the key research by Rosenhan (1973) could have been improved
(6 marks)
What is the structure and points to include
Structure:
2 improvements
- Improvements need to actually be improvements (rather than changes) and they should be described rather than simply identified.
- Candidates need to contextualise their suggested improvements to the Rosenhan study.
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Include:
. collect data from a larger number of hospitals and/or from hospitals beyond the USA.
. Having the pseudopatients present with more than one set of symptoms
. formally testing whether there were any tendencies towards inaccurate diagnosis based on the age, gender or ethnicity of the person presenting with the symptoms (or, indeed, on any characteristics of the diagnosing practitioner).
Compare the characteristics of an affective disorder with the characteristics of a psychotic disorder.
8 marks
What is the structure and points to include
Structure:
Give 2 comparison points
> can be similarity or difference
Guidance point of comparison:
1 mark - similarity / difference between sets of characteristics is identified
1 mark - discussed / elaborated
1 mark - supported by relevant evidence from one disorder
1 mark - supported by relevant evidence from the other disorder
Repeat this for the second comparison point
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A01 (4 marks)
Demonstration of knowledge and understanding of the different disorders is likely to be achieved through accurate reference to their characteristics in context
Characteristics of an affective disorder:
candidate may refer to the symptoms of depression or bipolar disorder;
Characteristics of a psychotic disorder, the candidate may refer to the symptoms of schizophrenia
AO3 (4 marks)
. Points of comparison are likely to centre on the characteristics themselves (e.g. hallucinations; flattened mood; effects on sleeping),
. Could broaden out into the level of insight the individual has of their condition, whether they retain contact with reality, effects on personality, etc.
. Reference could also be made to the ways in which the characteristics are known about (e.g. via self-report or observation; from the individual themselves or those around them)
Key companion points:
. Symptoms of the disorders
. How long the symptoms for
When people feel unwell, they often consult the website of the National Health Service (NHS). The way illnesses are described on the NHS website needs to be extremely clear.
Describe the characteristics of an affective disorder in a way that could be included on the NHS website.
5 marks
What would you write and would you structure this.
A01 (1 mark)
Candidates will demonstrate knowledge and understanding by referring to the characteristics of an affective disorder in support of points made within their answer.
Any appropriate affective disorder can be referred to.
AO2 (4 marks)
Candidates should apply their knowledge and understanding of the characteristics of an affective disorder to the context of the question.
Answers can be expected to outline some of the symptoms that characterise an affective disorder with either depth or breadth;
To access the top band, candidates must make explicit reference to the context of the question (i.e. a way in which it could be included on the NHS website).
- Write it like it is on the website.
- Use “ you”
Discuss ethical considerations of the research by Rosenhan (1973).
6 Marks
How would you structure this?
What does the word discuss mean
Structure
Give 2 points
Conclusion
AO1
Candidates will demonstrate knowledge and understanding by accurately referring to the detail of the key research by Rosenhan.
Ethical considerations apply to all aspects of the research (i.e. the people studied, the pseudopatients, social sensitivity, the language of
‘consent’, ‘withdrawal’, etc., and also the language of
“integrity’, ‘respect’, etc.).
A03
Discuss
Say why the study was ethical and say why it isn’t
Study stayed within ethical guidelines:
(e.g. in study 2, the hospital consented to be involved)
Study breached ethical guidelines: (e.g. in study 1, the staff in the hospitals were deceived about the status of the pseudopatients - i.e. they weren’t real patients).
It is acceptable for discussion points made to be criticisms or praise (i.e. they don’t have to be on both sides of the argument).
Other appropriate responses should be credited.
The key research by Rosenhan (1973) was carried out in the USA. Within this study, staff in a psychiatric hospital rated how likely it was that patients were pretending to have a mental illness.
Of the 193 patients judged in this way, 19 were suspected of being fake patients by a psychiatrist and one other staff member.
(a) Outline one way this finding illustrates reliability.
[3 marks]
(b) Outline one way this finding illustrates ethnocentrism.
[3 marks]
How do you answer these.
. Can use information provided for answer
Eg
A)
Inter rate reliability - two members of staff in agreement with each other
Large enough sample to establish a trend - judgements were made on 193 patients
B)
. Study was carried out in USA
Then expand on this: therefore the study only tells us about diagnosis of mental illness in the USA and nowhere else
Outline on way of defining abnormality
2 marks
Structure:
Outline 1 definition
Give a example
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Example answer:
For example:
One definition of abnormality is failure to function adequately in normal life. For example if a person is unable to work, maintain healthy relationships or physically take care of themselves, they may be classed as abnormal.
Rosenhan (1973) hypothesised that psychiatrists cannot reliably tell the difference between people who are sane and those who are insane.
With reference to the key research, discuss how classification of mental illness can result in ‘stickiness of labels
5 marks
What can you include
Overview:
Labelling:
Talking
Making notes
History fits label
Schizophrenia in remission
A01 (1 mark)
Demonstration of knowledge and understanding through reference to Rosenhan’s study.
A03 (4 marks)
Stickiness of labels is analysed in terms of the behaviour meted out by the staff, due to the initial labelling by the doctors who admitted the pseudo patients and/or the stickiness of the labels shown by the pseudo patients being discharged with the label of
‘Schizophrenia in remission’
’ Discussion of the classification of
mental illness demonstrates analysis of the information, ideas and evidence from the Rosenhan study and the associated issues. This includes engagement with the discussion which could be in terms of the labelling being due to cultural expectations or the problems of using diagnostic criteria leading to labelling.
> The key discussion should focus on how the classification resulted in the stickiness of labels.
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Example answer
The behaviour and case histories of Rosenhan’s pseudo-patients were interpreted by hospital staff in light of the original label of mental illness given by the doctor when admitted. For example, one pseudo-patient’s note-making was seen as a behavioural manifestation of their mental disorder, rather than a normal pastime. Another pseudo-patient’s typical marriage (close and warm with occasional arguments) was seen as evidence of his lack of emotional stability. This demonstrates that the label of mental illness can bias the interpretation of behaviour, leading to inaccurate diagnoses.
Furthermore, patients were discharged with the label of “schizophrenia in remission” showing that, despite displaying no behaviour associated with mental disorders during their time spent in the hospital, the label had ‘stuck’.
Explain why labelling pl abnormal could be considered unethical.
3 marks
What could you include
Candidates could make reference to the anti-psychiatry movement or to people who were part of it.
For example, Szasz, who considers that labelling people as abnormal or mentally ill was a form of persecution akin to labelling people as witches in the mediaeval era, so this is unethical as it causes harm.
Szasz and others like Rosenhan believed that labels were sticky and dangerous and would mean people often could be treated differently, i.e. losing their liberty unfairly and unethically. This would mean extreme distress was caused.
Candidates could consider that labelling can lead to treatment for those considered abnormal, which might be seen as infringement of their rights or may cause harm such as side effects and therefore the treatment, or simply having the treatment, may be considered unethical.
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Example answer:
Labelling abnormality may lead to a doctor prescribing drugs as a treatment for a mental disorder. This may be unethical if the patient feels pressured into taking drugs that are not necessary or cause them harm via the negative side effects. Furthermore, labelling abnormality may lead to the patient having negative self-beliefs and feelings of hopelessness, worsening their quality of life.
Suggest how biological treatment can be used to treat one specific disorder. (5 marks)
What could you include and get marks for?
A02
Candidates are likely to refer to drug therapy, although references to other biological treatments (e.g. ECT, or psychosurgery) are also creditworthy.
Detailed knowledge could include: What a drug might be (e.g. SSRI) and how it works (e.g. by stopping reuptake of serotonin, thereby increasing the mood-enhancing effect of serotonin due to increased levels of serotonin in the synapse).
Answers must relate to one specific disorder.
Example answer:
One biological treatment for depression is biochemical or drug therapy. There are clear links between low serotonin levels and depression, and one treatment is the use of SSRIs (selective serotonin reuptake inhibitors) which act on the levels of serotonin, in order to increase them. Serotonin is a neurotransmitter which is transmitted across the synaptic gap, and once the neuron is stimulated the serotonin is taken back up by the original neuron, therefore leading to low levels. However, the SSRI prevents the reuptake and so the levels of serotonin in the synaptic gap remain high and therefore reduce the symptoms of depression.
Inhibited.
——————-
Key points
Make sure to name the specific disorder and the treatment first
Then go onto explain.
Drug therapy
. Explain the imbalance of neurotransmitters
. Explain what the drug does
Give 3 points can you write about when referring to the strength and weakness of a biological treatment
(Doesn’t just apply to a biological treatment)
- efficacy of treatment
- practical issues (cost, availability)
- side effects
In the key research by Szasz (2011), the author states that “there is no such thing as mental illness.” How does Szasz defend this claim?
3 marks
What is this question asking
. Szasz’s believe/view of mental illness
. Reasons behind his view
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What points to include:
Candidates could be expected to make reference to any of Szasz’s arguments.
Example:
. some bodily illnesses are wrongly diagnosed as mentäl illnesses,
. the term ‘mental illness’ reflects a judgement by other people about particular (bad’) ways of behaving;
.it’s a legal definition;
. it’s a medical construct;
. it’s a political construct;
. it’s society’s judgement.
(Although Szasz mentions derogatory labels he does not refer to labelling theory.)
Assess the usefulness of the key research by Szasz (2011).
5 marks
How many points should you include.
What could you include?
2 for useful and 2 for not useful
. 2 points
Points discussed need to be linked to usefulness
—————
AO2 (3 marks)
Candidates should apply their knowledge and understanding of the research by Szasz.
AO3 (3 marks)
‘assess’ - weigh up the usefulness of the Szasz study. (Why useful and why it isn’t)
Useful
. It exposes the politicisation and medicalisation of psychiatry trying to place limits on the powers of psychiatrists,
. It encourages “internal ministry’, and counselling voluntary clients.
Not useful
. negative views it conveys about psychiatrists and mental hospitals
. its central contention that there is no such thing as mental illness.
Compare the behaviourist explanation of mental illness with either the humanistic or the psychodynamic or the cognitive neuroscience explanation of mental illness
8 marks
. Structure
. Points to include
2 paragraphs
Marks:
1 mark - state similarity/difference
1 mark - explain / elaborate
1 mark - Behaviourist
1 mark - psychodynamic
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Points of comparison:
. debates (e.g. usefulness; social sensitivity; reductionism/holism)
. methodological issues such as the type of research supporting the explanation;
. area of psychology both explanations come from,
. the sorts of treatment they may lead to
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Examples
Point 1: Nature / Nuture (similarity both nurture)
Elaborate on nurture (environment influences behaviour)
Evidence - Little Albert (kehaviourist)
- Little Hans (psychodynamic)
Point 2: Research Methods (difference in control / data collection)
Evidence - Little Albert
- Little Hans
What issues you link to a question which asks to discuss ethics
- social sensitivity
- human rights
Explain how the key research by Gottesman et al. (2010) contributes to the medical model of mental illness.
5 Marks
How could you answer this
. Gottesman et al’s study suggests a genetic component to severe mental disorders;
. Better answers will quantify the extent of this genetic component or note that this genetic component may be greater for some disorders than others.
. Candidates must refer to the medical model of mental illness to access the top band.
AO1 (2 marks) - knowledge and understanding of Gottesman study
A02 (3 marks) - link study to contributing to medical model
To what extent do you agree with Szasz claim mental illness is a myth
5 marks
What points can you make
A01 (1 mark)
Arguments should be illustrated with appropriate examples (e.g. of medicalisation, politicisation, treatment, etc.)
AO3 (4 marks)
Candidates could present arguments on either side (or both sides) of this debate.
Agree with Szasz’s argument
. Refer to social control of people diagnosed with mental illness
. Could make points about the pharmaceutical industry’s financial interest in seeing ever more mental disorders discovered.
Disagree with Szasz’s argument
. referring to how people are often comforted by having their experience given a diagnostic label’,
. making the point that Szasz’s argument risks shutting off a range of ways of helping people that they often find really useful.
Explain how this treatment can contribute to the success of the economy and society
4 marks
How do you answer this type of question
Points made could centre on how the treatment might:
Economy
. enable the patient to return to work (or continue working),
. thereby benefitting the economy as they are working and presumably paying taxes rather than potentially being off ill and maybe requiring their employer to hire temporary staff to do their work and/or possibly claiming sickness benefits.
Society
. Benefits to society could centre on (for example) the patient being able to continue in caring roles and/or doing voluntary work as well as interacting successfully with friends, family, colleagues, etc.
