Psychological Problems Flashcards
Mental health problems
Difficulties in the way a person thinks/feels/behaves
Characteristics of ideal mental health
- self-attitude
- personal growth
- integration - coping with stressful situations
- autonomy
- accurate perception of reality
- mastery of environment - love/relationships/function at work
Cultural variations in beliefs about mental health
- England - hearing voices seen as symptom of schizophrenia, positive in other countries
- North Korea doesn’t recognise depression
How have incidences of mental health problems changed over time
- number of mental illnesses in UK increased - 1 in 2
- 24% adults accessing treatment in 2007, 37% in 2014
- Mind estimates there will be 2 million more by 2030
Increased challenges in modern living
- poverty/financial issues
- COVID-19
- getting older
- condense urban areas
How have poverty/financial issues influenced mental health problems
27% men report mental health problems in low income, 15% in high income
How has COVID-19 influenced mental health probems
- increased mental health problems as:
- less able to socialise - becoming isolated
- increased death of loved ones
How do condense urban areas influence mental health problems
- increased mental health problems as:
- less socialisation
- surrounded by people in same social cycle
Social stigma of mental health
Automatic negative response about mental health
How has lessening social stigma affected mental health problems
People may be more confident in seeking treatment to address issues
Individual effects of mental health problems
- damage to relationships
- difficulties coping with day to day life
- negative impact on physical wellbeing
Damage to relationships
- key element of relationship is communication - MHPs affect this ability
- can’t talk / understand others points
- fear judgment so avoid/isolate - can be misinterpreted by others
Difficulties coping with day to day life
- difficult to look after self - get dressed, clean, work
- may not distress patient but will others
Negative impact on physical wellbeing
- stress = cortisol
- cortisol prevents immune system working as well
- stressed people get more colds ect.
Social effects of mental health problems
- need for more social care
- increased crime rates
- implications for economy
Need for more social care
- social care - food, company, ect.
- taxes increase or other areas of tax use increase
Increased crime rates
- research shows MHPs means 4x more likely to commit crime
- also other factors affecting this like substance use
Implications for economy
- same amount spent on MH as education
- drug treatment reported to be cheaper than psychological therapy
- increase in dementia in aging population - more costly as time goes on
Depressioin
- abnormal state with prolonged sadness
- physical changs - smaller hippocampus + retracted frontal lobe
Types of depression
- unipolar
- bipolar
Unipolar depression
Depression where person only experiences 1 emotional state
Bipolar depression
Depression where person fluctuates between 2 states - depression and mania
Sadness
Normal human emotion to certain situations
Key symptoms of unipolar depression
- low mood or persistent sadness
- loss of interests/pleasure
- fatigue or low energy
Other symptoms of unipolar depression
- disturbed sleep
- poor concentration or indecisiveness
- low self-confidence
- poor or increased appetite
- suicidal thoughts/acts
- agitation or slowing of movements
- guilt or self-blame
How long must symptoms last for unipolar depression diagnosis
At least 2 weeks
How many symptoms are needed for mild unipolar depression
4
How many symptoms are needed for moderate unipolar depression
5-6
How many symptoms are needed for severe unipolar depression
7
Unipolar depression biological explanation PARTS
- neurotransmitters
- serotonin
- other affects of serotonin
- reasons for low serotonin levels
Unipolar depression biological explanation NEUROTRANSMITTERS
Messages that travel along neuron electrically + transmitted across synapse chemically
Unipolar depression biological explanation SEROTONIN
- high levels of serotonin in synaptic cleft = postsynaptic neuron stimulated more, improving mood
- low levels of serotonin in synaptic cleft = less stimulation of postsynaptic neuron, results in low mood
Unipolar depression biological explanation OTHER AFFECTS OF SEROTONIN
- affects memory, sleep, appetite
- links to characteristics of depression - lack of concentration, disturbed sleep, reduced appetite
Unipolar depression biological explanation REASONS FOR LOW SEROTONIN LEVELS
- genes - may inherit poor ability to produce serotonin
- diet - may have low levels of tryptophan (key ingredient of serotonin), high protein foods + carbohydrates contain tryptophan
Unipolar depression biological explanation STRENGTH
- supporting research
- McNeal + Cimbolic (1986) found lower serotonin levels in people with depression
- suggests link between low serotonin levels and depression
Unipolar depression biological explanation WEAKNESSES
- low serotonin levels could be caused by being depressed
- difficult experiences can cause low levels, result of psychological experiences
- reductionist - some with low serotonin levels don’t have depression, neurotransmitter explanation not enough
+ - depression may have other causes as well
- unlikely neurotransmitters alone explain depression, ‘diathesis-stress’ explanation suggests deppression can be caused by inheriting low serotonin levels (diathesis), also have stressful experiences like war (stress)
- combination may lead to depression
Unipolar depression psychological explanation PARTS
- faulty thinking
- negative schemas
- attributions
- leaned helplessness
Unipolar depression psychological explanation FAULTY THINKING
- focus on negatives, ignore positives
- causes feelings of hopelessness + depression
Unipolar depression psychological explanation NEGATIVE SCHEMAS
Negative self schema = likely to interpret all info about themselves negatively
Unipolar depression psychological explanation ATTRIBUTIONS
- process of explaining cause of behaviour
- Seligman suggested some people have negative attributional style
- internal - blame self for negative events
- stable - believe cause of failiure unchangeable
- global - apply negative outcome of 1 situation to all aspects of life
Unipolar depression psychological explanation LEARNED HELPLESSNESS
- Seligman suggested negative attributional style learnt (nurture)
- e.g- negative experience makes you want to escape, failing will make you stop trying
Unipolar depression psychological explanation STRENGTHS
- Seligman demonstrated process of learnt helplessness
- dog learnt to react to electric shock after bell rang by giving up, not trying to escape shocking floor anymore
- research supports explanation of depression due to negative attributions
+ - leads to ways of treating depression
- depression can be treated with CBT improving people’s thinking with thought diaries + disputing
- explanation can improve people’s mental health
Unipolar depression psychological explanation WEAKNESS
- opposing research
- Alloy + Abraham (1979) found depressed people gave more accurate estimate of likelihood of disaster than ‘normal people’ - sadder but wiser
- opposes negative attributional style ideas
Methods of treating depression
- antidepressant medications
- Cognitive Behaviour Therapy
How does serotonin release happen normally with no drugs
- serotonin stored in vesicles
- electrical signal opens vesicles
- serotonin released into synaptic cleft
- serotonin binds to postsynaptic receptors
- unused serotonin reabsorbed by presynaptic neuron
- serotonin broken down + reused
How do antidepressant meds work
Block reuptake to reduce symptoms of depression
SSRIs
Selective Serotonin Reuptake Inhibitor
SSRIs WEAKNESSES
- reductionist approach
- idea depression only caused by biological factor to action of neurotransmitters
- more holistic approach would look at psychological + biological factors
+ - questionable evidence for effectiveness
- takes 3-4 months for SSRIs to impact symptoms, should impact serotonin instantly so symptoms instantly, Asbert (1976) found serotonin levels may not be that different between depressed/normal anyway
+ - negative side effects
- dizziness, dry mouth, erectile dysfunction, may outweigh good
- people may stop taking them
CBT
Structured therapy that helps identify + change negative thought patterns/behaviours to improve mental health
Aims of CBT
- help patient change way they think
- help patient change way they act to improve symptoms
How does CBT change behaviour
- changes thinking through changing behaviour
- behavioural activation - plan pleasant activity everyday (making meal) leading to feeling of accomplishment, positive emotions lead to positive mood
CBT methods
- disputing
- thought diary
CBT - disputing
Challenging clients’ irrational thoughts (asking for proof) to rationalise + increase self belief
CBT - thought diary
- client records unpleasant emotions + thoughts
- rate them on scale (1-100%) of how much they believe them
- client records more rational version of emotions/feelings, rate them
CBT STRENGTHS
- holistic approach
- focuses on treating whole person, not just constituents of depression (neurotransmitters), adresses problems on deeper psychological level
- likely more effective than antidepressants alone, deal with core symptoms
+ - long-lasting effectiveness
- long term aim of giving patient tools to deal with depression themselves, learn techniques to use again and again
- more useful, doesn’t just deal with current problems
CBT WEAKNESS
- not everyone willing to spend long-time for success
- clients often meet therapist every week for months + do homework between sessions, takes effort (SSRIs passive)
- many drop out, fail to benefit
Wiles DATE
2013
Wiles AIM
See if more holistic approach is better at treating depression - antidepressants only work for 30%
Wiles METHOD
- 469 Ps with treatment resistant depression (drugs not working after 6 weeks) from 73 different GPs with BDI score 14+
- independent groups - antidepressants only + antidpressents with CBT (12-18 sessions)
- randomly assigned to condition of IV with computer
- symptom changes measured with BDI - higher score = higher depression levels
Wiles RESULTS
- after 6 months, 90% of Ps remained
- antidepressants only - 21.6% had over 50% symptom reduction
- antidepressants + CBT - 41.6%
- results consistent after 12 months
Wiles CONCLUSION
- CBT useful addition to drugs
- should look at holistic biological + psychological treatment
Wiles STRENGTHS
- well designed to avoid EVs
- independent groups may have caused on group to have sadder Ps, group assignment random from computer + groups checked for similar BDI scores
- confident DV not interfered with by EVs
+ - ecological application
- focused on developing useful therapy, demonstrated holistic treatment can work, more successful than just drugs, therapy also cheaper (avg £343 / year)
- good reason for research
Wiles WEAKNESS
- ineffective self-report method
- subjective, Ps may not answer truthfully, some may under/overestimate how sad they feel
- reduced validity - not objective results
Addiction
- individual taking substance or doing behaviour that’s pleasurable, then becomes compulsive with harmful psychological/physical consequences - dependence + tolerance + withdrawals
- needing to have/do something regularly to avoid negative feelings + go about normal routine, take over interest in other activities + friends/family
Dependence
- compulsion to keep taking substance
- can still lead normal life
- signaled by physical/psychological withdrawals
Substance misuse
Using drug in wrong way
Substance abuse
Using drug for bad purpose - e.g- getting high instead of medicinal benefits
Clinical characteristics of addiction
- strong desire to use substance despite harmful consequences
- difficulty in controlling use
- higher priority given to the substance than other activities/obligations
- withdrawal state - tired/headache/anxiety
- evidence of tolerance
Hereditary factors
Information passed from 1 generation to the next, can lead to genetic vulnerability for a disorder if inherit certain genes
Genetic vulnerability
Genes do not determine disorder, increase risk of individual having disorder
Types of twin
- monozygotic
- dizygotic
Monozygotic twins
Share 100% of DNA
Dizygotic twins
Share 50% of DNA
Kaji’s twin study DATE
1960
Kaji’s twin study AIM
See if children inherit genetic vulnerability to become alcoholic
Kaji’s twin study METHOD
- 310 male Swedish twins - at least 1 registered on Swedish temperance board
- interviewed twins (sometimes relatives) - info about drinking habits + to see if twins were MZ/DZ
- 48 (mz), 126 (dz)
Kaji’s twin study RESULTS
- 61% identical twins both alcoholic
- 39% non-identical twins both alcoholics
Kaji’s twin study CONCLUSION
- suggests alcoholism related to hereditary factors
- results don’t 100% support idea of genetic vulnerability - must be environmental factors also
Kaji’s twin study STRENGTH
- supported by later research
- Kendler (1997) did better controlled study (2,516 twins), found if 1 co-twin alcoholic, other more likely to be also, 48% if MZ, 33% if DZ
- supports Kaji’s conclusions drawn, results consistent over time
Kaji’s twin study WEAKNESSES
- flawed design
- temperance board only includes some kinds of alcohol problems (drink driving + public drunkness), info MZ or DZ self-reported or from informant
- conclusions may not have been accurate
+ - biological addiction explanation may be misleading
- many assume inheriting certain genes makes addiction inevitable, genes increase risk but also nurture/environmental factors
- explanation implies genes more influential than they are
Psychological explanations of addiction
-
peer influence
-social learning theory
-social norms
-social identity theory
-opportunities for addictive behaviour
Peer
People who are your equal - e.g- same age
Peer influence
Effect peers have on us, strongest in adolescence when spending more time with peers than family
Social learning theory
- Albert Bandura
- learn by observing + imitating behaviour of others
- may happen unconsciously
- may be done as we see someone respected/rewarded for a behaviour
- more likely to imitate someone we admire + identify with
Social norms
Rules about behaviour that you learn from people around you, look at behaviour of others to decide how you should act
Social identity theory
Each of use belong to many groups, to be accepted by peers in group, must behave + think like them
Opportunities for addictive behaviour
- peers provide opportunity for something like smoking/drinking
- peers may also direct/instruct on what to do in such situations
Psychological explanation of addiction STRENGTH
- research support
- Simons-Morton + Farhat (2010) reviewed 40 studies into relationship between peers + smoking, found positive correlation
- doesn’t mean peer influence causes addiction but likely risk factor
Psychological explanation of addiction WEAKNESSES
- peer influence may work in other direction
- people may pick groups of peers who behave as they are
- shared addictive behaviours within group may be consequence of original addiction
+ - reductionist
- likely not peer influence alone influencing someone’s use of substances, also genetics, mental health issues, personality, past trauma, found to play role
- shouldn’t focus on single type of factor for accurate theory
Purpose of aversion therapy
Recondition brain to fight cravings to fight addiction
Aversion therapy method
- UCS - patient given something to cause negative feeling/reaction to NS - UCR
- repeat for few times
- CS causes negative feeling/reaction on its own - CR
Aversion therapy STRENGTH
- can be combined with CBT for greater effectiveness
- holistic approach can deal with addictive behaviour + underlying cognitive factors, therapist can focus on coping strategies for relapse
- can get rid of immediate urge to return whilst providing long-lasting support
Aversion therapy WEAKNESSES
- many addicts abandon therapy
- won’t work unless unpleasant, many drop out before completing treatment, difficult to assess effectiveness as those who stay more determined to overcome addiction
- difficult for research to come to generalisable conclusions
+ - benefits may be short-term
- McConaghy (1991) found aversion therapy effective in reducing gambling behaviour after a year, follow up after 9 years found therapy no more effective than placebo
- reduced validity
Self-management programmes
Therapy not needing licensed therapist to be carried out, patient control recovery individually, benefiting members also direct activities
Self-help groups
Peer sharing model when members support each other, contain/avoid religious ‘higher power’ aspects
12-step recovery programmes PARTS
- the ‘higher power’
- admitting and sharing guilt
- lifelong process
12 step recovery programmes HIGHER POWER
- 2,3,6,7
- addict surrenders their control to higher power
- even if non-religious, still letting go of free will
12 step recovery programmes ADMITTING AND SHARING GUILT
- 4,5,6,7,8,9
- members of group + ‘higher power’ hear confessions but still accept ‘sinner’
12 step recovery programmes LIFELONG PROCESS
- 10,11,12
- members of group continue to support each other
- keep book of names + phone numbers if feel they will relapse and need help
- carry message of 12 steps to others
12 step recovery programmes STREGNGTH
- holistic approach
- many steps deal with emotions, groups provide social support
- better than reductionist aversion therapy, only targets stimulus-response links
12 step recovery programmes WEAKNESSES
- lack of evidence indicating effectiveness
- Cochrane review systematically reviewed Ferri et al (2006), reported no significant differences between AA and other treatments, Gray (2012) found 81% left within first year
- difficult to draw conclusions
+ - may only be effective for certain types of people
- high dropout rates suggest it is demanding, continued attendance requires high motivation, some people may also not want to share personal experiences with group
- less useful, limited to particular people
