psych problems Flashcards
State 5 characteristics of good mental health
- Having good relationships with others
- Being able to deal with disappointments and problems
- Effectively coping with difficulties and challenges
- Being able to cope with stresses and demands of everyday life
- Positive engagement with society
Explain how increased challenge of modern living affects the amount of people suffering from depression
It is likely that economic deprivation is one explanation for rises in mental health problems. MIND reports that people living in lower income households are more likely tp have mental health problems (for example, 27% of men compared to 15% in higher income households)
Explain how cultural variations in beliefs about mental health affects the amount of people suffering from depression
In the Western world, ‘hearing voices’ is categorized as auditory hallucination and seen as a symptom of mental health problems such as schizophrenia. In other parts of the world, such as India or Africa, more people report hearing voices and regard it as a positive experience. The categories of mental health problems also vary around the world. Some mental health problems are called culture bound syndromes because they are only recognised in certain cultures. One example of this is ‘koro’ when a young man believes that his penis or nipples will retract into his abdomen, resulting in death. The disorder is found almost entirely in Asia.
Explain how increased recognition of the nature of mental health problems affects the amount of people suffering from depression
Another difficulty of the list of signs and symptoms relating to mental illness is that it is focused on illness instead of health. The signs of physical illness is based on a concept of what physical health looks like - we know ‘normal’ body temperature is as well as normal pain levels and normal skin condition. Jahoda suggested it might be more helpful to list the characteristics of mental health rather than illness and then look for the absence of these signs
Explain how reduced social stigma affects the amount of people suffering from depression
Once a person is called mentally ill or schizophrenic. Then other people have expectations about what the person will think and do. These expectations act as a stigma and may be harmful to the individual as they may affect how others treat the person and could lead to broader discrimination like difficulty finding jobs. In the past people who had psychological problems were called ‘lunatics’ Over time the label itself becomes a problem and therefore new labels are created. Therefore, the currently preferred term is ‘mental health problem’. This has less of a stigma attached to it and also emphasizes health rather than illness, putting a positive spin on the illness as a mental health problem, emphasizing the person can get better whereas, for example, lunatic implies something more permanent.
State the 6 effects of psych problems
- Damage to relationships
- Difficulties coping with everyday life
- Negative impacts on physical wellbeing
- Need for more social care
- Increased crime rates
- Implications for the economy
Explain the difference between sadness and depression
Sadness is a normal human emotion. It is a normal reaction to certain experiences such as the death of a beloved pet. Unipolar depression is an abnormal emotional state. It often occurs without any obvious reason/cause. One of the key characteristics of depression is sadness, but it is a deep sadness that lasts for a considerable amount of time. Sadness is not a pleasant emotion but it is not totally debilitating whereas a key characteristic of any mental disorder is that it stops a person from being able to function.
Explain the difference between unipolar and bipolar depression
Unipolar depression is also known as clinical depression, people experience a continuous low mood, loss of enjoyment and energy (1). Uni means one, meaning people only experience one emotional state (1). Whereas bipolar depression is also known as manic depression, people experience two types of mood change (1), As well as having depressive type symptoms such as low mood, people with bipolar have high moods such as mania (1).
Explain how psychiatrist would use the ICD 10 to diagnose different severities of depression
The ICD10 includes symptoms that are seen in people who have depression. A diagnosis of mild unipolar depression requires the presence of 2 of the 3 key symptoms, (low mood, loss of interest, and reduced energy levels), whereas a diagnosis of moderate depression would have to have 4 symptoms, and for a diagnosis of severe depression, 7 or more symptoms would have to be present. For a diagnosis of depression, these symptoms should be present most of the time, and longer than two weeks.
Other symptoms may include: changes in sleep patterns, changes in appetite levels, decrease in self confidence and ideas of self harm or suicide
Outline & evaluate the biological explanation of depression
The brain has billions of neurons which send messages to other neurons and the rest of the body. It does this by sending electrical impulses called action potential and chemical messages to jump over the synaptic junction called neurotransmitters.
Serotonin helps to control biological functions like sleep, aggression, appetite and mood. Research has shown that people with depression often have low levels of serotonin causing an imbalance. For example PET scans comparing depressed and non-depressed patient brains, showed depressed people had lower amounts of serotonin in the hippocampus. The hippocampus is in the temporal lobe and is responsible for memory and connecting emotions.
Reasons for low serotonin levels?
- Influence of nature: There are many reasons why some people have low serotonin levels. One is that genetics plays a role, in that people can inherit a poor ability to produce serotonin. We know that concordance rates are higher amongst identical twins than non-identical twins.
- Influence of nurture: Research has shown that a substance called tryptophan is a key ingredient in making serotonin. Tryptophan comes from foods which contain a high amount of carbohydrates which may explain why people binge eat on foods like pizza and potatoes, as they improve your mood and make you feel good.
A strength of the biological explanation is that it has supporting evidence. Genetic vulnerability to depression is supported by twin studies. McGuffin found the concordance rate of unipolar depression in MZ twins was 46% and DZ twins was 20%. These suggest a strong genetic influence on depression.
A weakness however, is that evidence from the twin studies could be flawed because it is very difficult to untangle genetic influences from environmental. This is because MZ twins are often treated very similarly by their parents and friends. Meaning it could have been an influence of nurture that resulted in their depression, not nature.
One weakness of the biological explanation of depression is that it is reductionist. This is a weakness because it explain depression in a reduced amount of serotonin and fails to consider other factors such as an individuals thinking and mindset. Therefore, this reduces the validity of the biological explanation and researchers should take a holistic approach to understand depression
Outline & evaluate the biological treatment for depression
Antidepressant medication relates to a class of drug called SSRIs (selective serotonin reuptake inhibitors). These work by increasing serotonin levels in the brain by affecting the process of synaptic transmission which is how neurons communicate with each other. Under normal circumstances, serotonin is released by certain neurons in the brain. It is stored at the end of a transmitting neuron in tiny vesicles. The electrical impulse travelling through the neuron makes the vesicles release this neurotransmitter into the synaptic cleft. Serotonin molecules convey the signal from the presynaptic neuron to the postsynaptic neuron by attaching themselves to postsynaptic receptor sites. At the end of the process, the remaining serotonin left at the synapse is reabsorbed back into the presynaptic neuron.
People with depression have lower levels of serotonin in their brains so there is less serotonin available to the postsynaptic neurons in order to convey messages to improve mood. SSRI antidepressants work by preventing serotonin from being reabsorbed into the presynaptic neuron so that more serotonin is available at the synapse to bind to receptors on the postsynaptic neuron.
One weakness of using antidepressant medication like SSRIs is that these drugs have side effects. This is a weakness because it may cause nausea and dizziness, other side effects may be headaches + insomnia. Therefore the side effects may out weigh the benefits as the patient may need to take further medication for the side effects.
Another weakness of antidepressant medication is that it is regarded as reductionist. This is because depression can be caused by cognitive features rather than just low levels of serotonin. Prescribing anti-depressants to increase serotonin levels doesn’t resolve the issue and the patient may benefit from therapy more. Therefore a holistic approach should be taken and a psychological approach should be considered.
A strength of using antidepressant medication is that they are cheaper than other treatments. This is a strength because it’s more accessible for people who are suffering from depression compared to therapy and other treatments for depression. Therefore treatment can be conducted on a larger scale allowing people to overcome depression
Outline & evaluate the psychological explanation for depression
The cognitive approach suggests that the reason some people are depressed is because of their faulty or irrational thinking. The schema (mental framework) we have about ourselves and the world around us affects how we think about things. If we have a negative schema then all the information about ourselves is interpreted in a negative way. This is glass half empty thinking and can lead to depression.
Attributions is the process of explaining behavior, normally linked to one’s personality. Seligman suggested that some people have a depressive or negative attribution styles.
There are different types of attribution styles:
- Internal: dispositional factors, eg. personality
- External: situational factors, eg. weather
- Stable: fixed/no change, eg. gender
- Unstable: temporary, eg. tired
Depressed people tend to have internal and stable attributions.
Seligman suggested that a negative attribution style is learned (nurture) and the person gives up trying, called learned helplessness.
One weakness is that the cognitive explanation is limited. This is because depression can be caused by biological factors such as low serotonin levels, so only treating a patient with therapy and CBT may not resolve the underlying issue, and the patient may benefit more from SSRIs. Therefore, a holistic approach should be taken and a biological approach should be considered.
Another weakness is that cognitive explanation is oversimplified as it reduces complex human behavior to rational and irrational thoughts. It is not clear whether the irrational thoughts cause depression or depression causes the irrational thoughts, and therefore its difficult to establish a cause and effect relationship.
A strength is that the cognitive explanation leads to ways of treating depression. For example, cognitive behavioral therapy is to help people to learn differently: if faulty irrational thinking underlies depression, then learning to think rationally should relieve depression. Therefore the value of the cognitive explanation is that it leads to a very successful way to treat people with depression
Outline & evaluate the psychological treatment for depression
CBT (cognitive behavioral therapy) is the most commonly used treatment for depression. The therapy aims to deal with thinking, such as challenging irrational/negative/maladaptive thoughts. These are thoughts that are likely to interfere with a person’s happiness leading to depression.
Based on the negative triad, these thoughts must be challenged. It also forces people to test the reality of their own negative beliefs. In between sessions they will be set cognitive homework tasks, eg. to record an event they enjoyed or when someone was nice to them. This is referred to as ‘patient is scientist’ with the patient actively testing the reality of their rational beliefs.
One strength is lots of supporting evidence. March (2007) investigated the effectiveness of CBT in treating depressed people who have not improved after taking SSRIs. Participants were randomly allocated to have CBT alongside their medication or continue medication alone, where those receiving CBT noticed an improvement in their life quality. This is a strength as it shows when used in addition to antidepressants , CBT is an effective way of reducing symptoms of depressions, rather than just drugs alone.
Another strength of CBT is that it is cognitive, as it looks at the person’s complex mix of thoughts and feelings. This may be a better treatment as it deals with the core symptoms of depression, rather than just the individual parts, e.g. low moods, meaning it’s ultimately more effective than the reductionist biological approach.
A weakness of CBT is that it’s not suitable for all patients, as some cannot motivate themselves to engage with the hard cognitive work of CBT as it takes a lot of will power and commitment. In this case it may be more appropriate to use antidepressant medication meaning a limitation of CBT is that it can’t always be used as the sole treatment for all cases of depression
Outline & evaluate Wiles’ study
The aim of the study was to investigate the effectiveness of CBT in treating depressed people who have not improved after taking medication. 234 participants were randomly allocated to have CBT as well as their normal antidepressants. And a control group of 235 participants just continued to take their normal antidepressant medication. Participants in the CBT group had 12 one-on-one one hour sessions of CBT. After 6 months, 46% of the CBT group showed improvements in symptoms compared to 22% in the control group. Wiles concluded that when used in addition to antidepressants CBT is an effective way of reducing symptoms of depression rather than just using drugs alone.
One strength is that Wiles study had high control over extraneous variables. This is because participants were randomly allocated to either the CBT or control group, helping to minimise individual differences. This enables a greater cause and effect relationship between the IV and DV to be established, increasing the internal validity of the findings.
Another strength of Wiles study is supporting evidence for the effectiveness of CBT. March (2007) compared CBT with antidepressant drugs and a combination of the two in 327 teenagers who had depression. After 36 weeks, 81% of the CBT group, 81% of the antidepressant group and 86% of the CBT plus drugs group were significantly improved. This is a strength as it shows just as effective as medication without of the risks and side effects of drugs.
One weakness of the study is that it used self report measures to establish depression levels. Participants could have shown social desirability where they want to portray themselves in the best possible light, so lie and say that they are improving and fell less depressed. Also judging how you feel is subjective and some people might over or under estimate their feelings of sadness
Define addiction
Repeated use of a substance resulting in an individual becoming entirely focused on the substance which they need to have regularly in order to avoid withdrawal symptoms
