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historical context of mental health Flashcards

1
Q

what are the historical views of mental health in BC?

A

madness was believed to be the cause of mental illness in prehistoric times. trepanation was used in 6500BC through the discovery of skulls with holes drilled in them.

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2
Q

what did the ancient greeks think about mental illness?

A

they also used trepanation. like other early civilisations, they blamed mental illness on demonic possession and used exorcisms, beating and starvation to drive out the demons. around 500BC hippocrates theorised the cause was an imbalance of four bodily humours.

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3
Q

why did hippocrates’ theory advance our understanding of mental illness?

A

because it suggests physical changes have caused mental illness, and began the medical model of medicine in europe.

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4
Q

what were the historical views of mental illness around 300AD?

A

the christian church helped link madness to mental illness- as a punishment from god. began to use bloodletting again along with prayers.

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5
Q

what was mental illness like in the 19th century?

A

psychiatry became a recognised medical speciality, and mental hospitals were established across britian and america.

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6
Q

when did modern psychology begin?

A

the 1890s, and developed the idea that mental illness is the result of varying influences.

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7
Q

what were treatments in the 1900s?

A

in the 1900s lobotomies and leukotomies were used. a leukotomy destroyed specific areas of the brain, and electro-shock therapy passes an electric current through the pre-frontal lobe. this resets the electrical rhythm in the brain but destroys the short term memory.

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8
Q

what are some newer treatments?

A

prescription drugs and talking cures. consists of therapy, systematic desensitisation, cognitive behavioural therapy and counselling.

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9
Q

what is the predominant approach?

A

the biological, medical model

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10
Q

how did stratton and hayes define abnormality?

A

statistical infrequency; deviation from social norms; failure to function adequately; deviation from ideal mental health

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11
Q

what is statistical infrequency?

A

behaviour that is 3 s.d away from the average is abnormal.

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12
Q

issues with statistical infrequency

A

implies there is a normal curve for behaviour; doesn’t take into account desirability of behaviour (having a IQ is rare but still desirable)

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13
Q

what is deviation from social norms?

A

viewing abnormality in terms of breaking society’s standards or norms. behaviour that deviates from implicit/explicit rules or moral standards.

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14
Q

issues with deviation from social norms

A

who decides social norms? it is too subjective- at what point does a behaviour become an abnormality?

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15
Q

what is failure to function adequately?

A

viewing abnormality as the failure to experience the normal range of emotions or to engage in normal behaviour. can be indicated by dysfunctional behaviour or observer discomfort.
maladaptiveness

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16
Q

issues with failure to function adequately

A

what constitutes dysfunction? what is distress? is behaviour truly irrational or just judged to be? hard for psychologists to agree on boundaries that define ‘functioning’ and ‘adequately’- leads to inconsistency

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17
Q

what is deviation from ideal mental health?

A

identifies characteristics that people should possess to be considered normal, such as: positive self view, accurate perception of realty, positive social interactions.

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18
Q

issues with deviation from ideal mental health

A

shows that statistical infrequency is not necessary for identifying abnormality

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19
Q

what are the main classification systems that categorise mental illness?

A

the DSM-V and ICD-10

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20
Q

what is the ICD-10?

A

an international classification of diseased and related health problems. includes 11 categories of mental disorder, which each have a description of the main features. each disorder is given a code.

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21
Q

what is the DSM-V?

A

the diagnostic and statistical manual of mental disorders is a multi-axial tool. clinicians have to consider which axis the disorder is from, then they can consider the mental condition of the patient.

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22
Q

benefits of the classification systems

A

both generally accepted to be valid; encourage consistency; constantly being updated

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23
Q

limitations of the classification systems

A

cultural bias can influence the creation of categories; treatment can be complicated if patients fall into multiple categories; ICD uses categories in a reductionist way and the DSM separates mind from body

24
Q

how many culturally related diagnoses are in the chinese classification of mental disorders?

A

40

25
Q

what was a new addition to the DSM-V in 2013?

A

internet gaming disorder

26
Q

what was removed from the DSM in 1986?

A

homosexuality

27
Q

what percent of the panel working on the DSM-V had links to the pharmaceutical industry?

A

69%

28
Q

what does rosenhan’s (1973) study aim to do?

A

test that psychiatric diagnosis is neither reliable nor valid

29
Q

rosenhan (1973) on being sane in insane places- study one, method

A

eight psuedopatients were admitted to twelve psychiatric hospitals in america, after claiming to hear the words ‘empty, hollow, and thud’. all but one were admitted with schizophrenia, and stopped displaying symptoms once admitted. staff made type one errors.

30
Q

rosenhan (1973) on being sane in insane places- study one, results

A

spent 7-52 days in hospital, an average of 19 days. discharged with ‘schizophrenia in remission’, and all their behaviour was interpreted within the context of schizophrenia. normal relationships were interpreted in a dysfunctional way, queuing early for lunch was ‘oral-acquisitive syndrome’, taking notes was ‘writing behaviour’ and pacing in boredom was seen as nerves.

31
Q

responses to requests made to psychiatrists

A

7%

32
Q

responses to requests made to nurses

A

3.6%

33
Q

amount of time spent with psychologists

A

average was less than 7 minutes a day

34
Q

rosenhan (1973) on being sane in insane places- study two, method

A

told a larger research hospital to expect psuedopatients over the next three months.

35
Q

rosenhan (1973) on being sane in insane places- study two, results

A

41/193 patients tested were suspected of being psuedopatients, however no psuedopatients were actually sent. staff made type two errors to avoid making type one errors.

36
Q

powerlessness in rosenhan’s study

A

feelings of powerlessness were seen in the restricted contact with staff and lack of privacy. no confidentiality regarding patients’ notes, which were openly read by staff who had no therapeutic contact with the patient. initial physical examinations took place in a semi-public room.

37
Q

depersonalisation in rosenhan’s study

A

some staff engaged in physical abuse of patients in the presence of other patients, but not around other staff as they could be considered credible witnesses. one nurse undid her uniform in full view of male patients. 2100 pills administered to the psuedopatients. staff did not challenge the many patients who disposed of their medication.

38
Q

symptoms of affective disorder- depression

A

extreme sadness, loss of interest, disturbed sleep, changed activity level, disturbed appetite

39
Q

which type of depression is more common?

A

unipolar depression

40
Q

symptoms of anxiety disorder- ocd

A

recurrent unwanted thoughts (obsessions) and repetitive behaviour (compulsions). repetitive behaviours are to prevent obsessive thoughts, and performing these compulsions provides temporary relief from anxiety

41
Q

symptoms of psychotic disorder- schizophrenia

A

positive symptoms are an excess of normal function, and two or more positive symptoms need to be present for at least a month.
negative symptoms are a loss of normal function.

42
Q

positive symptoms of schizophrenia

A

hallucinations (perceptual disturbances); delusions (disturbances of thought); disordered thinking and speech- cannot concentrate thoughts into a logical sequence and difficulty communicating

43
Q

what are paranoid delusions?

A

where the person believes they are being persecuted or plotted against

44
Q

what are delusions of granduer?

A

where the person believes they are famous/very important

45
Q

what are delusions of control?

A

where the person thinks their thoughts are controlled in some way or are receiving special messages

46
Q

negative symptoms of schizophrenia

A

affective (emotional)- a reduction in the range/intensity of emotional expression; poverty of speech- reduction in speech, fluency and willingness to talk; reduced motivation

47
Q

issues with categorising mental disorders

A
  • validity of diagnostic tools can be questioned. ford and widiger (1989) found that presenting the same symptoms to practicioners but changing the gender of patients resulted in a different diagnosis. women diagnosed with histronic disorder vs men with antisocial disorder
  • no category of mental disorder has consistently high reliability. only three mental disorders have a satisfactory kappa score. no better than fair for schizophrenia and psychosis, and poor for all remaining categories.
48
Q

when was the first recorded treatment of mentally ill patients?

A

1403, six men diagnosed of ‘insanity’

49
Q

when did the practice of publicly viewing inmates at madhouses and asylums continue until?

A

1815

50
Q

rosenhan- methodological issues

A
  • challenges reliability of diagnostic processes and treatment of patients
  • important ethical considerations, stickiness of labels, cost-benefit of talking therapy, drug trials
  • staff were decieved by psuedopatients, harmful environment for patients
51
Q

rosenhan- usefulness of research

A
  • educating staff

- changing fundamental methods of practice involving diagnosis and treatnent of the ‘insane’

52
Q

rosenhan- nature vs nurture

A
  • explores how environment affects mental health, and the treatment we recieve from others
  • labels make it difficult to have behaviour percieved as any other than abnormal
53
Q

rosenhan- free will vs determinism

A
  • psuedopatients lacked free will. similar exerience to those sanctioned under the mental health act.
  • diagnosis of a mental disorder was a ‘forever label’. stigma can affect how others treat them
54
Q

rosenhan- reductionism vs holism

A
  • defining abnornamlity is highly reductionist.

- using criteria to capture mental illness is reductionist, and cannot offer a complete picture of any disorder

55
Q

rosenhan- individual vs situational

A
  • DSM used to diagnose individuals
  • situational factors can cause ‘abnormal’ behaviour to be misinterpreted- all behaviour regarded in context of being mentally ill -> powerlessness and depersonalisation.
56
Q

rosenhan- psychology as a science

A
  • throughout history, views on mental illness have shifted from religious to spiritual to scientific
  • biological explanations for mental illness, e.g. hormone issues, genetic causes.
  • using objective measures, e.g. DNA, blood testing, brain-scanning
  • treatments such as chemotherapy
  • definitions of abnormality range from highly scientific to subjective. DSM is not reliable or valid.

Psychology (18 decks)

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