psychological problems Flashcards
incident of mental health problems
depression
2.6/100
anxiety
4.7/100
ed
1.6/100
incidence changing over time
more women than men
gap widening
2007-24%
2014-37%
challenges of living
lower income household more mental health problems
greater social isolation increases loneliness and depression
cultural variations in beliefs about mental health problems
hearing voices - positive experience in some parts of india
culture bound syndromes occur in some cultures
characteristics of mental health
subjective and arbitrary
difficulty sleeping are hard to measure
increased recognition of mental health problems
symptoms focused on illness rather than health
jahoda criteria
jahodas criteria
self attitudes
personal growth and self actualisation
integration
autonomy
accurate perception of reality
mastery of env
lessening social stigma
labelling ppl creates an expectation
term mental health problems creates less stigma
effects of mental health problems
damage to relationships
difficulty coping with day life
negative impact on physical well being
characteristics of mental health
damage to relationships
affect two way communication relationships need
difficulty coping with day life
not liking after self eg getting dressed
negative impact of physical well being
body produces cortisol
prevention immune system functioning properly
causing more illness
characteristics of mental health
subjective and arbitrary
difficulty to sleep hard to measure
social effects of mental health
need for more social care
increased crime rates
implications for economy
need for more social care
taxes fund social care providing food, human company, learning new skills for self care
increased crime rates
4x more likely to commit crime than normal population
eg due to substance abuse
implications to economy
mccrone report: care for mentally ill costs £22 bil per herat
cheaper drug treatments needed
types of depression
clinical
unipolar
bipolar
clinical
term for the medical condition
unipolar
one emotional state of depression
bipolar depression
depression alternates with mania
also periods of normality
ICD
mental and physical disorder diagnosed using symptoms
ICD-10 current version listing symptoms
key symptoms of depression
low mood
loss of interest and pleasure
reduced energy levels
changes in sleep
change in appetite
decrease in self confident
guilt
pessimism
self harm
theories of depression
biological and psychological
biological explanation
neurotransmitters transmit messages chemically across synapse
low levels at synapse lead to less stimulation of postsynaptic neuron causing low mood
effects of low serotonin
lack of conc
disturbed sleep
reduced appetite
reasons for low serotonin
genes could cause inheritance of low levels
low levels of tryptophan from lack of protein or carbohydrates
strength of biological explanation
supporting research
low levels of serotonin in depressed brains in comparison to control group (mcneal and cimbolic 1986)
weakness of biological explanation
low levels of serotonin could be an effect of being depressed rather than a cause
negative thoughts lead to changes in brain
just like learning changes neurons and production of neurotransmitters in brain
may be an effect of psychological experiences rather than cause
weakness of biological explanation
may not be solely caused by abnormal levels of neurotransmitters
explanation too simple
some with low serotonin dont have depression
diathesis stress model better explanation
depression result of ppl having certain vulnerabilities eg inheriting low serotonin
also have stressful experience
combination of diathesis and stressor
psychological explanation
faulty thinking
negative schemas
attributions
influence of nurture
faulty thinking
caused by irrational thinking
negative black and white thinking creates feelings of hopelessness
negative schemas
cause person to interpret all info abt self negatively
attributions
internal stable and global negative attributions styles
creates negative ways of explaining causes of behaviour
influence of nurture
negative attributional styles develop through processes such as learned helplessness
if unpleasant experience
natural reaction is to try and escape
if they can’t they learn to give up trying
this is called learned helplessness
explains how a person learns to blame things on themselves and believe it will always be like that
strength of psychological explanation
research support for learned helplessness
seligman demonstrates process of learned helplessness
dogs that no longer tried to escape electric shocks that they previously had no control over
similar to depression
person will have leaned to react to challenge by giving up
dogs previous negative attribution caused them to give up
strength of psychological explanation
real world application
cognitive explanations lead to ways of treatment
cognitive behaviour therapy (CBT)
ppl learning to think differently
if irrational thinking underlies depression then learning to think rationally should help relieve depression
leads to successful way to help ppl with depression
weakness of psychological explanation
negative beliefs may be realistic than depressing
some life experiences realistic to be sad
person with opposite attributional style may have a problem instead in some situations
alloy and abramson 79
depressed ppl have more accurate estimates of chance of disaster
negative attributional style may actually be more accurate way of looking at world
antidepressant medication
group of drugs
reduce symptoms
eg
SSRI
aim to increase amount of serotonin at synaptic cleft
SSRI
selective serotonin reuptake inhibitor
increase serotonin levels at synaptic cleft
presynaptic neuron
serotonin stores in vesicles
impulse in neuron causes vesicles to release serotonin into the synaptic cleft
synaptic cleft
serotonin locks into postsynaptic receptor transmitting signal form presynaptic neuron
reuptake
after serotonin conveys signal by locking into a receptor site
taken back to presynaptic neuron where it is broken up and reused
ssris block uptake so there is more serotonin in synaptic cleft
ssris occupy reuptake transporter
weakness of antidepressants
serious side effects
eg nausea insomnia weight loss or suicidal thoughts
lack of control in own body
may seem easier than cbt
serious threat to effectiveness of drug therespies
weakness of antidepressants
evidence for effectiveness is questionable
3-4 months of ssris to have impact on symptoms
doesnt make sense if drug is increasing quantities of serotonin immediately
placebo effect
they believe they are receiving treatment leading to improvement
weakness of antidepressants
reductionist
suggest neurotransmitters are only factor that cause depression
reduces depression to act of neurotransmitters
may lead to overlook factors
more successful treatment might include biological and psychological approaches
cbt
cognitive behaviour therapy
method of treating using both cognitive and behaviour techniques
cbt
cognitive
aim to change faulty thinking and catastrophising to rational thinking
cbt
behaviour
behavioural activation
planning and doing a pleasant activity creates positive emotions
cbt
therapist dealing with irrational thoughts
disputing negative irrational thoughts to develop self belief and self liking
cbt
client dealing with irrational thoughts
thought diary
record unpleasant emotions and rational response to automatic thoughts is rated
strength of cbt
lasting effectiveness
supplies tools to help them deal with future episodes
apply learned techniques over and over again
long term
weakness of cbt
not willing to spend time and thought required for cbt
will likely take months off sessions with hw
ssris passive
cbt involves willingness to think about yourself
ppl may drop out of cbt
strength of cbt
holistic
treating whole person rather than focusing on constituent parts of depressing such as neurotransmitters
approach concerns higher psychological level of what person thinks or feels
deals with core symptoms
more effective
wiles aim
investigate benefit of holistic approach (cbt combines with antidepressant) to treat treatment resistant depression rather than antidepressant alone
wiles method
469 from bristol exeter glasgow
73 gp practices
all had TRD
all took antidepressant for more than 6 weeks and still showed symptoms of clinical depression
randomly assigned to one of two conditions using a computer generated code
1. antidepressant only
2. antidepressant and cbt
measured symptoms of depression using bdi
bdi
beck depression inventory
measures symptoms of depression
wiles results
end of 6 months 422 stayed in study
1. 21.6% had more than 50% reduction in symptoms
2. 46.1% had more than 50% reduction in symptoms
end of 12 months 396 remained
2. showed greater recovery and remission (symptoms do not return)
wiles conclusion
cbt useful addition to treatment
2. more than effective
benefits can be maintained over 12 months
strength of wiles
control ev
potential ev participants conditions
independent groups design
to control participants randomly assigned to groups
initial bdi scored checked to see on average similarity
figure for comparison was amount of improvement rather than level of depression
changes in dv not affected by ev
weakness of wiles study
self report to determine levels of depression
subjective judgements
untruthful answers
might underestimate sadness or overestimate
questions validity of info
strength of wiles study
focused on developing useful therapy
main aim to demonstrate in a well controlled study that more holistic approach can be more successful
cheap experiment
£343 per year
real world usefulness one of main reasons conducting research
addiction
activity has become most important thing in that persons life
takes over interest in all other activities
addiction prime defining characteristics
dependance
substance abuse
dependence versus addiction
dependence: psychological relieve/ stop withdrawal symptoms
addiction: dependence plus the sense of escape (mood modification)
substance misuse versus abuse
misuse is not following the rules
abuse is using substance to gain sense of escape
difference is persons intentions
diagnosing addiction
ICD-10 states addiction diagnosis is made only if 3 or more characteristics are present together during previous year
characteristics from ICD-10
strong desire to use substance
persistence to use despite harm
difficulty controlling use
withdrawal symptoms
higher priority given to substance
influence of nature in addiction
hereditary factors (inheritance)
genetic vulnerability
hereditary factors
addictions can be highly inherited
genetic information may determine whether you are likely to become addicted

genetic vulnerability
multiple genes are involved in addiction not just one
addiction genes may increase the risk that you become addicted
diathesis stress poses that a genetic vulnerability is only expressed persons life stresses and experiences act as a trigger
kaijs aim
to see whether alcoholism could be explained in terms of hereditary factors
kaijs method
male twins from aweden
identified using temperence board regustration data
temperance board to register and follow individuals with alcohol abuse
310 male twins where at least one registered
interviews
also with close relatives
to collect info on drinking habits and if twins were identical or not
384 twin participants
48 identical (monozygotic same genes)
126 non identical (dizygotic 50% same genes)
iv is genetic similarity
kaijs results
Percentage of twins who had a co twin registered with the board was higher for identical twins then non-identical
identical 61%
non identical 39%
kaijs conclusion
alcoholism is related to hereditary factors
but not entirely otherwise it would be 100%
if alcoholism had no genetic content then data for both types of twins would be same
supports idea of vulnerability
genetic component neither 100 or 0
increased social problems suggest env factors contribute
weakness of kaijs study
flaws in design
not studying alcoholism
board only includes some types of alcoholism
those who made public display
eg drunk driving
data on mz vs dz were self reports
may not be accurate
lacks validity
strength of kaij
supprted by later reseach
kendler 97
more controlled study using larger sample
2516 individual twins
also found that both more likey to be alcoholic if they’re mz
supports view that genetic factors have a influence in alcoholism
weakness of kaij
biological explanations of addiction may be misleading
makes it seem addiction inevitable
genes are not only factor
both nature and nurture important
implies genes are more influential than actually are
psychological explanation
peer influence
being influenced by those around you
who you deem equal
social learning theory
learn through obsevring others and imitate rewarded behaviours
identify with peers and more likely to imitate them
social norms
look to others to see what is acceptable creating social norms
may be overestimated
social identity theory
we identify with and want to br accepted by social groups
creates pressure to conform to social norms
creating opportunities for addictive behaviour
peers provide opportunities for addictive behaviour
provide direct instruction
strength of peer influence as explanation for addiction
research support
morton and farhat 2010
reviewed 40 studies
relationship between peers and smoking
all but one showed positive association
suggests peer influences are risk factor
weakness of peer influence as explanation for addiction
may not work in that direction
peer selection
people who have an addiction actively select others who are like them rather than conforming to the social norm of the group
addictive behaviours shared within a group happen as a consequence of addiction rather than the group causing addiction through social norms and group pressure
strength of peer influence as an explanation for addiction
real world application
hansen and graham 91
compare to programs for reducing substance abuse
one resistance skills and other normative education (learning about acceptability in peers)
latter programme greater success
socials norms marketing advertising used to address social norms issue
popular approach in US
applications demonstrate positive value of peer influence explanations
aversion therapy
classical conditioning
association between addiction and unpleasant experience is learned
treating alcoholism
antabuse nausea and vomiting
before vomiting alcoholic has several drinks
neutral stimulus (alcohol)associated with unconditional response (vomiting) which becomes conditioned response
treating gambling
phrases on cards about gambling or non gambling behaviour
electric shock given to any gambling phrase
gambling associated with pain
treating smoking
rapid smoking in closed room causes nausea
associated with smokinh
weakness of aversion therapy
may abandon
unpleasant stimuli
difficult to assess effectiveness because in research studies those who stay in a study longer tend to cope well with unpleasantness and may have stronger desire to overcome addiction
difficult to come to any conclusion
weakness of aversion therapy
short term rather than long term
follow up of-up to nine years aversion therapy no more effective than placebo
overt aversion lacks overall effectiveness
strength of aversion therapy
can be combined with cbt for greater effectiveness
holistic approach
some underlying factors that may have claimed addiction can be targeted as part of cbt
therapist can focus on coping strategies for when individual thinks relapse is near
provided longer lasting support targeting persons thoughts and feelings
12 step recovery
organise therapy without professional guidance
eg
AA alcoholics anonymous
list
eg
2 find hope in higher power
9 make amends
higher power
giving control to higher power and letting go
religious
admitting and sharing guilt
members of group and higher power blister to confession to accept sinner
lifelong process
recovery never complete
offer support incase of relapse
self help groups
peer sharing and support
may avoid religious aspects
local tradition may be included
weakness of self management
lack research in 12 step programme
AA said in 2007 33% of 8000 North America numbers have remained sober for 10 years or more
doesn’t include information on how many left the program with no success
another report in 1990 stated 81% left within year
difficult to obtain clear data on overall effectiveness
weakness of self management
May only be effective for certain types of people
dropout rates suggest self-help approach is quite demanding
requires high levels of motivation
some people may not wish to share their experiences and emotions
limited treatment
strength of 12 step recovery program
focus on the whole person
holistic approach
concerned with providing social support to help a person cope with their emotions
contrasted with more reductionist programs such as aversion therapy which target stimulus response links
