Week 2 Flashcards
Single test vs longitudinal report recall of mental illness
Shows that we may grossly underreport mental illness as people fail to recall it. Less so with physicL illness. Maybe due to stigma or cognitive decline. Longitudinally study. 4 waves dam iii
Hue article psychiatry
Psychotherapy and pharmacotherapy,
Togethor slightly more effective, but overall only .5 effect size, as good as any drug,
Interestingly many issues in methodology, the pharmacologic trials and psychotherapy in some disorders are indadequTe. There need to be more research to compare the two synergistically and directly, with control groups. Large funding and sample needed. Psychotherapy has slight edge. Of course there are exceptions to everything.
Perspectives, ways to understand abnormal PSYC.
Astronomy, earth’ sage, we are so small.
Prevalence
Prevalence
How frequent a disorder is,
Aside : Trixhotolomania, pulling hair disorder
Cost: ex. Schizophrenia
328 billion, mental illness
1/3 hospital stays due to mental illness
We spend about 10€ per person mental siaoeswe
66$ for cancer
Msd dystrophy 200$ muscular
Issues in measuring prevalence
Ppl not good at understanding own situations and self ratings
Introspection illusion,
Half individuals should see as below norm, nope, ex. Above average effect, tend to judge ourselves, ex. Students!
Personal invidicual judgment, professional, rely on own theories and views, biased, 82% of regular ppl interview were psychotic or presychotic, diagnosis did not agree! unreliable diagnosis and treatments! hence dam to regulate.
Operational
-dam 5 measures reliability
Wwe see ourselves as
Beliefs not fact,
Measurement
Interviews - judgment
Worst, lots of error, reflected beliefs biases
Problem reliability and validity
Structured interview,
-DIS, diagnostic instrument service, cisi, composite instrument diagnostic interview.
Can’t trust epidemiological surveys but they are the best we have.
Problem is that there is no gold standard (measure 100% sure this indivuals with this characteristic have this problem).
Huntingtons disease, dominant inheritable disease, 30-40 brain deteriorate rapidly and generally, motor control lost and other senses, cease being human, heritable.
Look for gene, gold standard, predict, hunting tons. Change function of gne research now being looked at. Wow.
Ppl who know, suicide, 50% chance to give to their child remember.
No specific gene for schizophrenia,
Where to sample
In a hospital? Look at five classes, tell characteristics Suicidal depressives, Threatening suicide Angry psychotics Angry geriatrics Antisocial addicts Socail isolates
Success rates are very low,
These are severem patients,
Shows issue of efficacy, long hospital stays,
Zmajority world wide mental problem are
Never treated,
Reality don’t look in hospital for cases, as most don’t go into a hospital. Treated by others but?
30% of pop is diagnosable! yet 2/3 or 20p are not treated, that the MJority, well known phenomenon.
Schiz 32% not treats,,
50% depressed and others not treated.
More individuals with no disorder than with sever disorders were treated. 90% get medication!
Most get antidepressants, and not because ppl are necessarily depressed. Doc reflex, for winers, I past it was Valium, antipsychotics are now increasing especailly in young.
Problems with drugs
Side effects,
Antipsychotics make you gain weight, and type 2 diabetes reflects this.
O
Drugs do help, not cure
Schiz,
For others psychotherapy better,
Looking at study we had to read for class Most ppl do not need drugs, but are stuck with them, difficult to develop new drugs, probably won't see many new come along. Me too drug, copy and change slightly! Only difference in side effects, not efficacy. Average 18yrs from lab to patient! For new drug
Issues in measuring prevalence
Don’t look in mental institutions,
Deinstitutionalizations
–started in the 60’s
Reaction against them, get rid, community facilities, alternatives, driving factor was also cost. Community approaches failed, not supported enough, or effiencet to support need
Largest institutions
356.260 vs 350000
Cook county jail, prison as largest,mental disorder places,
12-50%
Frequent flyers
More likely 2x to get arrested for same crime and as non mentally I’ll,
Unwillingness to deal with ppl in severe pain.
Mental health courts
Improved likelyhood not of being arrested, getting treatment needed instead. Hmm
Prevalence of mental illness in homeless is
High,
20-60% 20 only in Halifax, most 40-60
Bi-polar cultural difference
ADHD brain disorder issue
Ideological factors, making it higher prevalence in US
Westernized developed cultures had their unique disorders
Africa mind you has too few studies.
ADHD more prevalent in us than europe
Notion mental illness is a brain disorder.
Prevalence of ADHD as a diagnosis, treatment with drugs. Graph.
September 1st birthdate issue. Diagnosed, because they fit the paradigm, neuro crates disease, made up rules for school, but problem is that kids immature, problems, and get labeled, and affects rest of their lives, all because of their birthday!
May be for many othe disorders too.
NHL story
Birthday, new year born, means more likely, than end of year born, big difference, cut off jam 1.
Rue for so many, all because of b day, you are more mature. Advantaged older kids.
Spirit of the time, zipegyte,
Ab PSYC, brain problem, not all
True, not all
Criminalizing mental illness article
As we saw in class, jail”/ have become largest met al health institutions, because of deinstitutionalization ppl are on the street and commit crimes, so sad, tried different things to correct educTimg officers helps but force still used. I humane conditions, problem is now!
Pharmacotherapy article
Treatment objective quaLity
And effectiveness
Meta analysis.
.5 effect of treatment, not huge
Stratify epidemiological study
Each person age ethnicity, randomly sampled. Important for validity.
Mental illnesses differ by
Gender, age (mine) , marriage, rtic.
Exa study, NCS replication
States, major university in each city used,
Dis, response rate imp. 68-79% good but not great return.
Ibi
Is mental illness increasing,
No, definitions are changing, is it legitimate.
12 month com orbidity, or called
Heterotrophic continuity
Odds are high, have one mental illness, means have another.
Ex. 50% will have another! like depressed and anxious. ADHD, and conduct disorder.
Heterotrophic continuity why’s
One disorder causes another
Both disorders may be the consequence of another disease.
There is reciprocal causality cokeethylene
Symptoms overlap
We donot have separate disorders
Factor analysis suggests
Fewer mental disorders, only 5-6
3 factors, in another study,
Suggests interrelation of disorders
NCS rep found
Anxiety disorders should be found around 11, treatment doesn’t occur til 10-20 years later.
Mood disorders, 30 yrs old, mean is wrong though.
In other words, treatment comes much later than onset in almost all disorders.
Prevalence for anxiety disorder 30%
Gender and mental illness
Brain difference, men half wits.
Mean alcohol, women schiz, slight, living longer. Depression.
Eating disorders, depression,
Women more often diagnosed, but childhood disorders are not included, which is 17:3 male female,
So adults more women diagnosed, and more male kids diagnosed
Because males are more disruptive! Similar for substance abuse disorders. Masked depression?
NCS 18-29
Any Anxiety Disorder 30.2 (Specific and social phobias 13.5% each)
Any Mood Disorder 20.8 ( Major Depression 15.4% )
Any Impulse Control Disorder 26.8
Substance Use Disorder 16.7
Depression
Mean 30.
Due to outlier of old age depression, in fact female teens have it worst.
Self esteem and gender
Equal at 14, boys it raises, and girls it declines orv time.
Women face more pressures?
Essential importance of description,
1973 rosenthan, study
7 friends, called mental institutions, “hearing voices, “
Empty hollow thud,
Diagnosis, schizophrenia, hospitalized 7-52 days, titled sane in insNe places. Lost of pills.
Schizophrenia in remission
Saw normal behaviour as pathological behaviour,
Context defined perceptions.
Hypothesis myopia! Lol
Often ppl avoided, patient question
True, in wards, apparently ppl are more attentive.
Non-issues
Lie, believed patients, hospitalization,
Real issue
A problem of definition,
Dam iii more specific,
The importance of desertion
Ppl said hallucinating.
Slater opening the Skinner box,
And a better ex.
9 ear visits
Voice, thud,
Depression with psychotic features
Bad book,
Another ex. Semmelweis obstetrician
Child birth issue
Wash hands imp, as autopsy deliver baby spread.
Death rate fell.
S was run out of medecine.
Absurdity,
Complex problems often have easy to understand wrong answers
Attachment therapy.
Child release angry, must be reborn, redevelop attachments, brutalize kid though. Pseudo scone or ppl kill her?
Stages of explanation,
Scientific approach
Mystical: possessed by demons
Taxonomic : classificAtion, dsm does this.
Scientific
Generally accept non scientific answers
Dsm v authorities, paid by drug companies.
Goals of science
Describe
Measure
Predict
Control
Dmpc
Description
Not easy
Often interpret info! Rat ex.
University valid statements.
High valijd, like horoscope. Yeah right.
Just describing something doesn’t explain it. Circular statements no good.
Measures meant
Po valley, self report, measure be, 40 000/day. Vs 15 000 report.
Ok
